Organization
FARMINGTON MISSOURI HOSPITAL COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T PORTACCI (SR VICE PRESIDENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
1212 WEBER ROAD, FARMINGTON, MO 63640
(573) 756-4581
(573) 756-5834
Mailing address
1212 WEBER ROAD, FARMINGTON, MO 63640
(573) 756-4581
(573) 756-5834
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047951132
TAX ID
MO
Enumeration date
07/03/2006
Last updated
08/22/2020
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