# BOTHWELL REGIONAL HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BOTHWELL REGIONAL HEALTH CENTER
- **Other names:** BHC - Truman Lake
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043399371
- **Legal business name:** BOTHWELL REGIONAL HEALTH CENTER
- **Authorized official:** JAMES A ROBERTSON (CFO)
- **Authorized official phone:** (660) 827-9482

## Contact information

- **Practice address:** 1765 COMMERCIAL ST, WARSAW, MO 65355-3096
- **Practice address phone:** (660) 468-3800
- **Practice address fax:** (660) 438-6525
- **Mailing address:** 601 E 14TH STREET, PO BOX 1706, SEDALIA, MO 65301-5972
- **Mailing address phone:** (660) 826-8833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 04/17/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 22602015 | BLUE CROSS BLUE SHIELD OF KC | MO |
| 05 | — | 505432005 | — | MO |