TEXAS COUNTY MEMORIAL HOSPITAL NPI 1265754501

NPI Information

NPI: 1265754501
Provider Name: TEXAS COUNTY MEMORIAL HOSPITAL

Doing Business As: TCMH - MOUNTAIN GROVE CLINIC

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

Specialization: Rural Health

CLIA Number: 26D2006074

Address:
1905 WEST 19TH STREET
MOUNTAIN GROVE, MO
ZIP 65711
Phone: (417) 926-1770
Get Directions

TEXAS COUNTY MEMORIAL HOSPITAL is a rural health clinic center in Mountain Grove, MO. TEXAS COUNTY MEMORIAL HOSPITAL NPI is 1265754501. The provider is registered as an organization entity type.
The provider Is Doing Business As Tcmh - Mountain Grove Clinic.

The provider's business location address is:

1905 WEST 19TH STREET
MOUNTAIN GROVE, MO
ZIP 65711
Phone: (417) 926-1770
Fax: (417) 926-1785

The provider's authorized official is Linda J. Pamperien .
The authorized official title is Chief Financial Officer and has the following contact phone number (417) 967-3311.

The CLIA number assigned to this NPI record is 26D2006074 - rural health clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/26/2010 and was last updated on 10/31/2016.

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
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1285957001	MEDICAID	MISSOURI
2	268653	MEDICARE OSCAR/CERTIFICATION	MISSOURI
3	26D2006074	OTHER	MISSOURI	CLIA
4	1265754501	MEDICAID	MISSOURI
5	MA2517	MEDICARE PIN	MISSOURI

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

NPI Synchronization or Removal

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