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Organization

MOBERLY HOSPITAL COMPANY LLC

Active
Other names
Moberly Regional Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
PAULA M LALOR (DIRECTOR / DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization

Contact information

Practice address
1515 UNION AVE, MOBERLY, MO 65270-9407
(660) 263-8400
Mailing address
PO BOX 60856, SAINT LOUIS, MO 63160-0856

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
423-9
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006895400
BLACK LUNG
05
011435005
MO
01
103184
UNITED HEALTHCARE
01
114
BCBS
01
5020191
PHP
01
652700000
CHAMPUS
Enumeration date
01/31/2006
Last updated
04/16/2021
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