# KENNETT HMA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Twin Rivers Medical Group-IM
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205387024
- **Authorized official:** PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
- **Authorized official phone:** (615) 925-4565

## Contact information

- **Practice address:** 1231 1ST ST, KENNETT, MO 63857-2527
- **Practice address phone:** (573) 888-8606
- **Practice address fax:** (573) 717-1085
- **Mailing address:** 1231 1ST ST, KENNETT, MO 63857-2527
- **Mailing address phone:** (573) 888-8606
- **Mailing address fax:** (573) 717-1085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 5147 | MO | Yes |

## Other

- **Enumeration date:** 10/17/2016
- **Last updated:** 10/09/2017