Organization
KENNETT HMA LLC
Active
Other names
Twin Rivers Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
1301 1ST ST, KENNETT, MO 63857-2525
(573) 888-8421
(573) 888-5525
Mailing address
PO BOX 281375, ATLANTA, GA 30384-1375
(573) 888-8421
(573) 888-5525
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
4861
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010492809
—
MO
01
—
184
BLUE CROSS
MO
Enumeration date
05/28/2006
Last updated
03/09/2018
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