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HANNIBAL REGIONAL HEALTHCARE SYSTEMINC NPI 1083154991


NPI Information

NPI: 1083154991
Provider Name: HANNIBAL REGIONAL HEALTHCARE SYSTEM,INC

Doing Business As: EXPRESS CARE AT WALMART

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 26D2029622

Address:
3650 STARDUST DR
HANNIBAL, MO
ZIP 63401
Phone: (573) 231-0660
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HANNIBAL REGIONAL HEALTHCARE SYSTEM,INC is a rural health clinic center in Hannibal, MO. HANNIBAL REGIONAL HEALTHCARE SYSTEM,INC NPI is 1083154991. The provider is registered as an organization entity type.
The provider Is Doing Business As Express Care At Walmart.

The provider's business location address is:

3650 STARDUST DR
HANNIBAL, MO
ZIP 63401-480
Phone: (573) 231-0660
Fax: (573) 231-0687

The provider's authorized official is Robert Gasaway .
The authorized official title is Cfo and has the following contact phone number (573) 406-1609.

The CLIA number assigned to this NPI record is 26D2029622 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/27/2017 and was last updated on 2/27/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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