Organization
TEXAS COUNTY MEMORIAL HOSPITAL
Active
Parent organization
TEXAS COUNTY MEMORIAL HOSPITAL
Other names
TCMH FAMILY CLINIC - LICKING
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEXAS COUNTY MEMORIAL HOSPITAL
Authorized official
MRS. LINDA J PAMPERIEN (CFO)
(417) 967-3311
Entity
Organization
Contact information
Practice address
139 W HIGHWAY 32, LICKING, MO 65542-9898
(573) 674-3011
(573) 674-4765
Mailing address
139 W HIGHWAY 32, LICKING, MO 65542-9898
(573) 674-3011
(573) 674-4765
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447412770
RH - MEDICAID
MO
01
—
26D0679044
CLIA
MO
Enumeration date
06/27/2008
Last updated
07/12/2024
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