Organization
PERRY COUNTY HEALTH SYSTEM
Active
Other names
PERRY COUNTY MEMORIAL HOSPITAL HOME HEALTH CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY WOLF (VICE PRESIDENT OF FINANCE)
(573) 547-2530
Entity
Organization
Contact information
Practice address
2 CIRCLE DR, PERRYVILLE, MO 63775-1248
(573) 547-7133
(573) 517-0347
Mailing address
434 N WEST ST, PERRYVILLE, MO 63775-1359
(573) 547-7133
(573) 517-0347
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
651-7
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123
BLUE CROSS PROVIDER #
MO
05
—
580157204
—
MO
Enumeration date
09/02/2005
Last updated
04/13/2012
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