Organization
STE GENEVIEVE COUNTY MEMORIAL HOSPITAL
Active
Other names
Bloomsdale Rehab, Bloomsdale Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WOLK (BUSINESS OFFICE DIRECTOR)
(573) 883-7703
Entity
Organization
Contact information
Practice address
255 BODERMAN, SUITE 1C, BLOOMSDALE, MO 63627
(573) 883-4473
(573) 883-4472
Mailing address
PO BOX 468, STE GENEVIEVE, MO 63670-0468
(573) 883-4488
(573) 883-4472
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010491801
—
MO
Enumeration date
08/14/2012
Last updated
03/06/2026
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