| Organization Name: | JOHN FITZGIBBON MEMORIAL HOSPITAL, INC. |
| NPI Number: | 1073748786 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DARIN L HAUG (PRESIDENT & CEO- FITZGIBBON HOSPITA) |
| Mailing Address: | 2305 South 65 Highway Marshall |
| State: | MO US |
| Postal Code: | 653403702 |
| Phone Number: | 6608867431 |
| Fax Number: | 6608869001 |
| NPI Enumeration Date: | 05/26/2009 |
| NPI Last Update Date: | 02/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WW0000X |
| License Number: | 109128 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Wound Care |
| Taxonomy Definition: | |