1811062375 NPI number — HERMANN AREA HOSPITAL DISTRICT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811062375 NPI number — HERMANN AREA HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HERMANN AREA HOSPITAL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASSOCIATED MEDICAL ARTS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811062375
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 19
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERMANN
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65041-0019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-486-1193
Provider Business Mailing Address Fax Number:
573-486-0910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
504 N STURGEON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTGOMERY CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63361-1829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-564-2990
Provider Business Practice Location Address Fax Number:
573-564-2963
Provider Enumeration Date:
11/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCKINNEY
Authorized Official First Name:
DAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
573-486-2191

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 590420808 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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