Organization
PEMISCOT COUNTY MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN WHITE-WAGONER (CEO)
(573) 359-3612
Entity
Organization
Contact information
Practice address
946 E REED ST, HAYTI, MO 63851-1243
(573) 359-1372
(573) 359-3601
Mailing address
PO BOX 489, 946 EAST REED, HAYTI, MO 63851-0489
(573) 359-1372
(573) 359-3601
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26S070
MEDICARE PROVIDER
—
Enumeration date
03/24/2008
Last updated
09/27/2023
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