BLACK RIVER COMMUNITY MEDICAL CENTER NPI 1548546138

NPI Information

  • NPI: 1548546138
  • Provider Name: BLACK RIVER COMMUNITY MEDICAL CENTER
  • Classification: General Acute Care Hospital - 282NR1301X
  • Specialization: Rural
  • Entity Type: Organization
  • Doing Business As: BLACK RIVER MEDICAL CENTER
  • Address: 217 PHYSICIANS PARK DRIVE
    POPLAR BLUFF, MO
    ZIP 63901
  • Phone: (573) 727-9080

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NPI Details

BLACK RIVER COMMUNITY MEDICAL CENTER is a rural general acute care hospital in Poplar Bluff, MO. BLACK RIVER COMMUNITY MEDICAL CENTER NPI is 1548546138. The provider is registered as an organization entity type.
The provider Is Doing Business As Black River Medical Center.

The provider's business location address is:

217 PHYSICIANS PARK DRIVE
POPLAR BLUFF, MO
ZIP 63901-956
Phone: (573) 727-9080
Fax: (573) 778-0265

The provider's authorized official is Christy L Shawan .
The authorized official title is Ceo and has the following contact phone number (573) 609-2495.

The enumeration date for this NPI number is 10/26/2011 and was last updated on 11/18/2015.

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
1282NR1301XGeneral Acute Care HospitalRuralMISSOURIYes

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
1260227MEDICARE 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: 11/21/2025

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