# BREECH REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. John's Hospital - Lebanon, Home Medical Supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023002805
- **Authorized official:** MR. DAVID E. WILHITE (BOARD CHAIR)
- **Authorized official phone:** (417) 532-3177

## Contact information

- **Practice address:** 1200 DEADRA DR, LEBANON, MO 65536-4669
- **Practice address phone:** (417) 588-9330
- **Practice address fax:** (417) 588-0217
- **Mailing address:** 100 HOSPITAL DR, LEBANON, MO 65536-9210
- **Mailing address phone:** (417) 588-9330
- **Mailing address fax:** (417) 588-0217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 2003026558 | MO | Yes |

## Other

- **Enumeration date:** 09/07/2005
- **Last updated:** 08/22/2020