Organization
PEMISCOT COUNTY MEMORIAL HOSPITAL
Active
Parent organization
PEMISCOT COUNTY MEMORIAL HOSPITAL
Other names
Bootheel Primary Care New Madrid
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEMISCOT COUNTY MEMORIAL HOSPITAL
Authorized official
CATHY LACEY (CREDENTIALING DIRECTOR)
(573) 359-3659
Entity
Organization
Contact information
Practice address
555 VIRGINIA AVE, NEW MADRID, MO 63869
(573) 748-3107
(573) 748-3112
Mailing address
PO BOX 442, HAYTI, MO 63851-0442
(573) 359-3659
(573) 359-3608
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
597723402
—
MO
Enumeration date
04/03/2008
Last updated
06/22/2018
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