Organization
POPLAR BLUFF REGIONAL MEDICAL CENTER, LLC
Active
Other names
Poplar Bluff Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
2360 KATY LN, POPLAR BLUFF, MO 63901-2300
(573) 712-2546
(573) 712-2549
Mailing address
2360 KATY LN, POPLAR BLUFF, MO 63901-2300
(573) 712-2546
(573) 712-2549
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
268685
MEDICARE OSCAR
MO
Enumeration date
10/03/2012
Last updated
04/29/2021
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