NPIMap

Organization Active NPI

Citizens Memorial Hospital District

  • Durable Medical Equipment & Medical Supplies
  • Bolivar, MO
National Provider Identifier
1154598795
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
313-25 Issued in MO
Legal business name
CITIZENS MEMORIAL HOSPITAL DISTRICT
Practice address
1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone
(417) 326-6000
Fax
(417) 328-6242
NPI assigned
May 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Authorized official

Name
Donald J Babb
Title
Ceo
Phone
(417) 326-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 313-25 MO Primary

Addresses

Primary practice location

1500 N Oakland Ave
Bolivar, MO 65613-3011

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone (417) 326-6000

Other identifiers 1

IdentifierTypeStateIssuer
626364905MedicaidMO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1154598795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6000",
            "fax_number": "417-328-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6000",
            "fax_number": "417-328-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITIZENS MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "BABB",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-326-6000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "313-25",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626364905",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.