Organization
MOBERLY HOSPITAL COMPANY LLC
Active
Parent organization
MOBERLY HOSPITAL INC.
Other names
Moberly Regional Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOBERLY HOSPITAL INC.
Authorized official
MICHAEL PORTACCI (SENIOR VP, GROUP OPERATIONS)
(888) 373-9600
Entity
Organization
Contact information
Practice address
1515 UNION AVE, MOBERLY, MO 65270-9407
(660) 263-8400
Mailing address
PO BOX 60856, SAINT LOUIS, MO 63160-0856
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
423-9
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110450
BLUE CROSS
MO
Enumeration date
02/01/2006
Last updated
02/15/2008
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