Organization
KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Active
Parent organization
KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Other names
Northeast Regional Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Authorized official
MICHAEL PORTACCI (SENIOR VP, GROUP OPERATIONS)
(888) 373-9600
Entity
Organization
Contact information
Practice address
315 S OSTEOPATHY, KIRKSVILLE, MO 63501-6401
(660) 785-1000
Mailing address
PO BOX 503525, SAINT LOUIS, MO 63150-3525
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
462-4
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10104
BCBS
—
Enumeration date
02/09/2006
Last updated
11/14/2007
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