MEDICARE: JOHN FITZGIBBON MEMORIAL HOSPITAL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	27-56	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730182478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN FITZGIBBON MEMORIAL HOSPITAL INC.

Provider Business Mailing Address
First Line	:	2305 S 65 HIGHWAY
Second Line	:
City	:	MARSHALL
State	:	MO
Zip	:	65340-3702
Country	:	US
Telephone Number	:	660-886-7431
Fax Number	:	660-886-9001

Provider Business Practice Location Address
First Line	:	2305 S 65 HIGHWAY
Second Line	:
City	:	MARSHALL
State	:	MO
Zip	:	65340-3702
Country	:	US
Telephone Number	:	660-886-7431
Fax Number	:	660-886-9001

Authorized Official
Title or Position	:	CFO/COO
Name	:	NANCY HARRIS
Credential	:
Telephone Number	:	660-886-7431

Provider Enumeration Date	:	05/26/2005
Last Update Date	:	03/05/2024

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