COOPER COUNTY MEMORIAL HOSPITAL NPI 1871626234

NPI Information

NPI: 1871626234
Provider Name: COOPER COUNTY MEMORIAL HOSPITAL

Doing Business As: CCMH FAMILY HEALTH CLINIC

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

Specialization: Rural Health

Address:
600 W MORRISON ST
SUITE 5
FAYETTE, MO
ZIP 65248
Phone: (660) 248-2900
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COOPER COUNTY MEMORIAL HOSPITAL is a rural health clinic center in Fayette, MO. COOPER COUNTY MEMORIAL HOSPITAL NPI is 1871626234. The provider is registered as an organization entity type.
The provider Is Doing Business As Ccmh Family Health Clinic.

The provider's business location address is:

600 W MORRISON ST
SUITE 5
FAYETTE, MO
ZIP 65248-075
Phone: (660) 248-2900
Fax: (660) 248-1544

The provider's authorized official is Danielle Gearhart .
The authorized official title is Admin Ceo and has the following contact phone number (660) 882-7461.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 7/25/2014.

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	590328506	MEDICAID	MISSOURI
2	26-3483	OTHER	MISSOURI	MEDICARE ID/OSCAR
3	263483	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	NF RHC
4	263483	MEDICARE OSCAR/CERTIFICATION	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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