Organization Name: | JOHN FITZGIBBON MEMORIAL HOSPITAL, INC. |
NPI Number: | 1316140494 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARIN L HAUG (PRESIDENT & CEO) |
Mailing Address: | 600 W Morrison St Suite 5 Fayette |
State: | MO US |
Postal Code: | 652481075 |
Phone Number: | 6602482900 |
Fax Number: | 6602481544 |
NPI Enumeration Date: | 06/07/2007 |
NPI Last Update Date: | 01/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |