Organization
POPLAR BLUFF NO 1 INC
Active
Other names
The Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD B BEDELL (PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
2071 BARRON RD, POPLAR BLUFF, MO 63901-1903
(573) 686-1147
Mailing address
PO BOX 1210, SIKESTON, MO 63801-1210
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
044995
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101456101
—
MO
Enumeration date
07/07/2006
Last updated
03/01/2017
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