Organization
MADISON MEDICAL CENTER
Active
Parent organization
MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME
Organization subpart
Yes
Provider details
NPI number
Legal business name
MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME
Authorized official
LISA M TWIDWELL (CFO)
(573) 783-3341
Entity
Organization
Contact information
Practice address
611 W MAIN ST, FREDERICKTOWN, MO 63645-1111
(573) 783-3341
(573) 783-1096
Mailing address
611 W MAIN ST, PO BOX 431, FREDERICKTOWN, MO 63645-1111
(573) 783-3341
(573) 783-1096
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621458009
—
MO
Enumeration date
11/22/2006
Last updated
09/18/2008
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