Organization
KENNETT HMA INC
Active
Other names
Gideon Rurual Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY PARRY ESQ (SR VP AND GENERAL COUNSEL)
(239) 598-3176
Entity
Organization
Contact information
Practice address
1301 1ST ST, KENNETT, MO 63857-2525
(573) 888-4522
Mailing address
1301 1ST ST, KENNETT, MO 63857-2525
(573) 888-4522
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
596948000
—
MO
Enumeration date
06/10/2006
Last updated
02/18/2009
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