Organization
STE GENEVIEVE COUNTY MEMORIAL HOSPITAL
Active
Other names
Me'Tis Breast Care
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WOLK (BUSINESS OFFICE DIRECTOR)
(573) 883-7703
Entity
Organization
Contact information
Practice address
120 PLAZA DR, STE GENEVIEVE, MO 63670-1828
(573) 883-2782
(573) 883-3684
Mailing address
120 PLAZA DR, STE GENEVIEVE, MO 63670-1828
(573) 883-5717
(573) 883-3684
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504887308
—
MO
01
—
CC8331
RAILROAD MEDICARE
MO
Enumeration date
01/13/2011
Last updated
01/13/2023
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