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Organization

KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC

Active
Parent organization
KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Other names
Family Health Center of Edina
Organization subpart
Yes

Provider details

NPI number
Legal business name
KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization

Contact information

Practice address
205 S 5TH ST, EDINA, MO 63537-1526
(660) 397-2400
Mailing address
PO BOX 7972, BELFAST, ME 04915-7900

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
462-4
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10294M
BCBS
05
597774900
MO
Enumeration date
02/17/2006
Last updated
04/28/2021
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