BLACK RIVER COMMUNITY MEDICAL CENTER NPI 1548546138

NPI Information

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:

Other Identifiers

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

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