# SOUTHEAST HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHEAST HOSPITAL
- **Other names:** Southeast Hospital ORLB
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1386311496
- **Legal business name:** SOUTHEAST HOSPITAL
- **Authorized official:** KRISTA BERRY (CONTROLLER)
- **Authorized official phone:** (573) 331-6028

## Contact information

- **Practice address:** 1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
- **Practice address phone:** (573) 334-4822
- **Mailing address:** 1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
- **Mailing address phone:** (573) 334-4822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 08/26/2021
- **Last updated:** 12/23/2021