# MISSOURI VALLEY REGIONAL MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992615371
- **Authorized official:** NICHOLAS DESTEFANE (AUTHORIZED SIGNATORY)
- **Authorized official phone:** (314) 543-3800

## Contact information

- **Practice address:** 2303 S HIGHWAY 65, MARSHALL, MO 65340-3734
- **Practice address phone:** (660) 886-7800
- **Practice address fax:** (660) 886-6044
- **Mailing address:** 1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 09/09/2026
- **Last updated:** 10/14/2026