Organization
PEMISCOT COUNTY MEMORIAL HOSPITAL
Active
Other names
Pemiscot County Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY NOBLE (CEO)
(573) 359-3612
Entity
Organization
Contact information
Practice address
946 E REED ST, HAYTI, MO 63851-1243
(573) 359-3612
(573) 359-3398
Mailing address
946 E REED ST, P O BOX 489, HAYTI, MO 63851-1243
(573) 359-3612
(573) 359-3398
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101493104
—
MO
Enumeration date
09/01/2006
Last updated
11/02/2011
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