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Organization

POPLAR BLUFF REGIONAL MEDICAL CENTER LLC

Active
Other names
Bloomfield Medical Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization

Contact information

Practice address
101 S. PRAIRIE, BLOOMFIELD, MO 63825-0200
(573) 568-3838
Mailing address
PO BOX 200, 101 S. PRAIRE, BLOOMFIELD, MO 63825-0200
(573) 568-3838

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
598557007
MO
Enumeration date
06/26/2006
Last updated
04/29/2021
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