Organization
POPLAR BLUFF REGIONAL MEDICAL CENTER LLC
Active
Other names
Poplar Bluff Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
3100 OAK GROVE RD., POPLAR BLUFF, MO 63901
(573) 686-5311
Mailing address
3100 OAK GROVE RD, POPLAR BLUFF, MO 63901-1573
(573) 712-2546
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
4852
MO
282N00000X
General Acute Care Hospital
Primary
4852
MO
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011602505
—
MO
05
—
541602504
—
MO
01
—
61
BLUE CROSS
MO
Enumeration date
05/24/2006
Last updated
04/20/2021
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