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Organization

POPLAR BLUFF REGIONAL MEDICAL CENTER LLC

Active
Other names
Malden 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
806 N DOUGLASS ST, MALDEN, MO 63863-1512
(573) 276-3873
Mailing address
806 N DOUGLASS ST, MALDEN, MO 63863-1512
(573) 276-3873
(573) 276-2625

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
593650005
MO
Enumeration date
06/14/2006
Last updated
04/20/2021
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