SOUTHEAST MISSOURI HEALTH NETWORK NPI 1649697566

NPI Information

NPI: 1649697566
Provider Name: SOUTHEAST MISSOURI HEALTH NETWORK

Doing Business As: CARUTHERSVILLE MEDICAL CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
CARUTHERSVILLE MEDICAL CENTER
109 EAST 5TH STREET
CARUTHERSVILLE, MO
ZIP 63830
Phone: (573) 359-9803
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SOUTHEAST MISSOURI HEALTH NETWORK is a federally qualified health center (fqhc) clinic center in Caruthersville, MO. SOUTHEAST MISSOURI HEALTH NETWORK NPI is 1649697566. The provider is registered as an organization entity type.
The provider Is Doing Business As Caruthersville Medical Center.

The provider's business location address is:

CARUTHERSVILLE MEDICAL CENTER
109 EAST 5TH STREET
CARUTHERSVILLE, MO
ZIP 63830-417
Phone: (573) 359-9803
Fax: (573) 359-0990

The provider's authorized official is Sarah Deane .
The authorized official title is Chief Financial Officer and has the following contact phone number (573) 313-2500.

The enumeration date for this NPI number is 3/28/2014 and was last updated on 5/22/2019.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			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	1649697566	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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