MEDICARE: HANNIBAL REGIONAL HEALTHCARE SYSTEM, 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	261QR1300X	Rural Health Clinic/Center

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

General Provider Information

NPI Number	:	1912926429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC

Provider Business Mailing Address
First Line	:	6000 HOSPITAL DR
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-6887
Country	:	US
Telephone Number	:	573-248-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	821 US HIGHWAY 24 AND 36 E
Second Line	:
City	:	MONROE CITY
State	:	MO
Zip	:	63456-1470
Country	:	US
Telephone Number	:	573-735-2506
Fax Number	:	573-735-1083

Authorized Official
Title or Position	:	CFO
Name	:	ROGER J DIX
Credential	:
Telephone Number	:	573-248-1300

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	11/20/2014

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