Organization
SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC
Active
Other names
MERCY HOSPITAL STODDARD
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA BERRY (CFO)
(573) 331-6028
Entity
Organization
Contact information
Practice address
1003 STATE HWY 25 NORTH, BLOOMFIELD, MO 63825
(573) 568-3686
Mailing address
PO BOX 368, DEXTER, MO 63841-0368
(573) 624-3165
(573) 624-3157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
599176906
—
MO
01
—
DC5318
RAILROAD MEDICARE
MO
Enumeration date
02/15/2007
Last updated
09/16/2025
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