# PEMISCOT COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gideon Family Rural Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124518451
- **Authorized official:** JAMES MARSHALL (CFO)
- **Authorized official phone:** (573) 359-3612

## Contact information

- **Practice address:** 100 S MAIN STREET, GIDEON, MO 63848
- **Practice address phone:** (573) 448-3800
- **Practice address fax:** (573) 448-8909
- **Mailing address:** PO BOX 489, HAYTI, MO 63851-0489

## Taxonomy

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

## Other

- **Enumeration date:** 05/11/2018
- **Last updated:** 07/19/2018