# POPLAR BLUFF REGIONAL MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bloomfield Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174550115
- **Authorized official:** PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
- **Authorized official phone:** (629) 215-3953

## Contact information

- **Practice address:** 101 S. PRAIRIE, BLOOMFIELD, MO 63825-0200
- **Practice address phone:** (573) 568-3838
- **Mailing address:** PO BOX 200, 101 S. PRAIRE, BLOOMFIELD, MO 63825-0200
- **Mailing address phone:** (573) 568-3838

## Taxonomy

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

## Other

- **Enumeration date:** 06/26/2006
- **Last updated:** 04/29/2021