NPIMap

Organization Active NPI

Ste Genevieve County Memorial Hospital

  • Community/Retail Pharmacy
  • Ste Genevieve, MO
National Provider Identifier
1124658232
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
STE GENEVIEVE COUNTY MEMORIAL HOSPITAL
Practice address
575 Pine Dr
Ste Genevieve, MO 63670
Phone
(573) 883-4415
Fax
(573) 883-4420
NPI assigned
Jan 17, 2020
Organization subpart
Yes
Parent organization
STE GENEVIEVE COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Authorized official

Name
Amanda Wolk
Title
Business Office Director
Phone
(573) 883-7703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

575 Pine Dr
Ste Genevieve, MO 63670

Mailing address

575 Pine Drive
Ste Genevieve, MO 63670
Phone (573) 883-4415

Other identifiers 1

IdentifierTypeStateIssuer
600091458MedicaidMO

Other names 1

  • Ste. Genevieve Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ste Genevieve Co Hospital17 organizations share this tax ID, including this one
Part of
Ste Genevieve Co Hospital

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1124658232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PINE DRIVE",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "63670",
            "telephone_number": "573-883-4415",
            "fax_number": "573-883-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 PINE DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "63670",
            "telephone_number": "573-883-4415",
            "fax_number": "573-883-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STE GENEVIEVE COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STE GENEVIEVE COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2020-01-17",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "WOLK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "573-883-7703"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600091458",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ste. Genevieve Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ste. Genevieve Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ste Genevieve, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.