NPIMap

Organization Active NPI

Madison Memorial Hospital Stockhoff Memorial Nursing Home

Doing business as Madison Medical Center

  • Pharmacy
  • Fredericktown, MO
National Provider Identifier
1003983859
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME
Doing business as
Madison Medical Center
Practice address
611 West Main Street
Fredericktown, MO 63645
Phone
(573) 783-3341
Fax
(573) 783-1096
NPI assigned
Nov 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lisa Marie Twidwell
Title
Cfo
Phone
(573) 783-3341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

611 West Main Street
Fredericktown, MO 63645

Mailing address

PO Box 431
611 West Main Street
Fredericktown, MO 63645
Phone (573) 783-3341

Other names 1

  • Madison Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ajay K Upadhyay MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003983859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 431",
            "address_2": "611 WEST MAIN STREET",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "63645",
            "telephone_number": "573-783-3341",
            "fax_number": "573-783-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 WEST MAIN STREET",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "63645",
            "telephone_number": "573-783-3341",
            "fax_number": "573-783-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TWIDWELL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-783-3341",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredericktown, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.