# BLACK RIVER COMMUNITY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Black River Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548546138
- **Authorized official:** MRS. CHRISTY L SHAWAN (CEO)
- **Authorized official phone:** (573) 609-2495

## Contact information

- **Practice address:** 217 PHYSICIANS PARK DRIVE, POPLAR BLUFF, MO 63901-3956
- **Practice address phone:** (573) 727-9080
- **Practice address fax:** (573) 778-0265
- **Mailing address:** 217 PHYSICIANS PARK DRIVE, POPLAR BLUFF, MO 63901-3956
- **Mailing address phone:** (573) 727-9080
- **Mailing address fax:** (573) 778-0265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | — | MO | Yes |

## Other

- **Enumeration date:** 10/26/2011
- **Last updated:** 11/18/2015