Organization Name: | PHELPS COUNTY REGIONAL MEDICAL CENTER |
NPI Number: | 1144386103 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN DENBO (CEO) |
Mailing Address: | 1000 W 10th St Rolla |
State: | MO US |
Postal Code: | 654012905 |
Phone Number: | 5734588899 |
Fax Number: | |
NPI Enumeration Date: | 12/27/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | 14-48 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |