Organization
KIRKSVILLE MISSOURI HOSPITAL COMPANY, LLC
Active
Other names
Northeast Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
315 S OSTEOPATHY, KIRKSVILLE, MO 63501-6401
(660) 785-1000
Mailing address
PO BOX 503525, SAINT LOUIS, MO 63150-3525
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
462-4
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00003296
NHC
—
05
—
010601201
—
MO
01
—
019600
FAMILY HEALTH
—
01
—
032145400
BLACK LUNG
—
01
—
0490756
AETNA
—
05
—
0537738
—
IA
01
—
068
WAL-MART
—
01
—
10559
BCBS
—
01
—
116833
HEALTHLINK
—
01
—
132726400
DEPT OF LABOR
—
01
—
1HR81
BC MN/KS
—
01
—
6350445
AETNA
—
Enumeration date
02/08/2006
Last updated
04/08/2021
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