Organization
BOTHWELL REGIONAL HEALTH CENTER ED
Active
Parent organization
BOTHWELL REGIONAL HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOTHWELL REGIONAL HEALTH CENTER
Authorized official
MR. DAVID WARREN HALSELL (CFO)
(660) 826-8833
Entity
Organization
Contact information
Practice address
601 E 14TH ST, SEDALIA, MO 65301-5972
(660) 826-8833
(660) 827-3742
Mailing address
PO BOX 1706, SEDALIA, MO 65302-1706
(660) 826-8833
(660) 827-3742
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00185-026
BLUE CROSS
MO
05
—
10157808
—
MO
05
—
540157807
—
MO
Enumeration date
05/06/2008
Last updated
05/06/2008
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