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MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME NPI 1316013139


NPI Information

NPI: 1316013139
Provider Name: MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME

Former Legal Business Name: MADISON MEMORIAL HOSPITAL

Classification: Medicare Defined Swing Bed Unit - 275N00000X
Entity Type: Organization
Address:
611 WEST MAIN STREET
FREDERICKTOWN, MO
ZIP 63645
Phone: (573) 783-3341
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MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME is a medicare defined swing bed unit in Fredericktown, MO. The provider is a unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME NPI is 1316013139. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Madison Memorial Hospital.

The provider's business location address is:

611 WEST MAIN STREET
FREDERICKTOWN, MO
ZIP 63645
Phone: (573) 783-3341
Fax: (573) 783-1096

The provider's authorized official is Lisa Marie Twidwell .
The authorized official title is Cfo and has the following contact phone number (573) 783-3341.

The enumeration date for this NPI number is 11/24/2006 and was last updated on 7/30/2008.


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
1275N00000XMedicare Defined Swing Bed Unit20945MISSOURIYes

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
126Z302MEDICARE OSCAR/CERTIFICATIONMISSOURI

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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