# HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC
- **Other names:** Canton/LaGrange Family Practice
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063431575
- **Legal business name:** HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC
- **Authorized official:** ROB GASAWAY (VP OF FINANCE)
- **Authorized official phone:** (573) 406-1608

## Contact information

- **Practice address:** 1802 ELM ST, CANTON, MO 63435-1694
- **Practice address phone:** (573) 655-4891
- **Practice address fax:** (573) 288-5361
- **Mailing address:** 6500 HOSPITAL DR, HANNIBAL, MO 63401-6890
- **Mailing address phone:** (573) 221-3415

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 05/25/2021