NPIMap

Organization Active NPI

Breech Regional Medical Center

Doing business as St. John's Hospital - Lebanon, Home Medical Supply

  • Oxygen Equipment & Supplies (DME)
  • Lebanon, MO
National Provider Identifier
1023002805
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
2003026558 Issued in MO
Legal business name
BREECH REGIONAL MEDICAL CENTER
Doing business as
St. John's Hospital - Lebanon, Home Medical Supply
Practice address
1200 Deadra Dr
Lebanon, MO 65536-4669
Phone
(417) 588-9330
Fax
(417) 588-0217
NPI assigned
Sep 7, 2005
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
Mr. David E. Wilhite
Title
Board Chair
Phone
(417) 532-3177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 2003026558 MO Primary

Addresses

Primary practice location

1200 Deadra Dr
Lebanon, MO 65536-4669

Mailing address

100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 588-9330

Other names 1

  • St. John's Hospital - Lebanon, Home Medical Supply Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Breech Medical Anesthes11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1200 Deadra Dr
Lebanon, MO 65536
Phone (417) 588-9330

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023002805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369210",
            "telephone_number": "417-588-9330",
            "fax_number": "417-588-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 DEADRA DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655364669",
            "telephone_number": "417-588-9330",
            "fax_number": "417-588-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREECH REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILHITE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "BOARD CHAIR",
        "authorized_official_telephone_number": "417-532-3177",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MO",
            "license": "2003026558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. John's Hospital - Lebanon, Home Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, 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.