Organization
SOUTHEAST HOSPITAL
Active
Parent organization
SOUTHEAST HOSPITAL
Other names
Southeast Hospital ORLB
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST HOSPITAL
Authorized official
KRISTA BERRY (CONTROLLER)
(573) 331-6028
Entity
Organization
Contact information
Practice address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 334-4822
Mailing address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 334-4822
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010417509
—
MO
Enumeration date
08/26/2021
Last updated
12/23/2021
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