Organization
PERRY COUNTY HEALTH SYSTEM
Active
Other names
PFCC WEST
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK CARRON (CEO)
(573) 547-2536
Entity
Organization
Contact information
Practice address
1508 EDGEMONT BLVD, PERRYVILLE, MO 63775-1231
(573) 768-3220
Mailing address
212 HOSPITAL LN, SUITE 101, PERRYVILLE, MO 63775-1224
(573) 768-3220
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114327954
—
MO
Enumeration date
08/29/2014
Last updated
09/24/2015
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