# PEMISCOT COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PEMISCOT COUNTY MEMORIAL HOSPITAL
- **Other names:** Bootheel Primary Care New Madrid
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1932372646
- **Legal business name:** PEMISCOT COUNTY MEMORIAL HOSPITAL
- **Authorized official:** CATHY LACEY (CREDENTIALING DIRECTOR)
- **Authorized official phone:** (573) 359-3659

## Contact information

- **Practice address:** 555 VIRGINIA AVE, NEW MADRID, MO 63869
- **Practice address phone:** (573) 748-3107
- **Practice address fax:** (573) 748-3112
- **Mailing address:** PO BOX 442, HAYTI, MO 63851-0442
- **Mailing address phone:** (573) 359-3659
- **Mailing address fax:** (573) 359-3608

## Taxonomy

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

## Other

- **Enumeration date:** 04/03/2008
- **Last updated:** 06/22/2018