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General John J Pershing Memorial Hospital Association

Organization Active NPI Health Service Clinic/Center · Brookfield, MO

NPI 1174979439 · NPPES record last updated Nov 8, 2023

Key facts

NPI
1174979439
Entity type
Organization (NPI type 2)
Primary specialty
Health Service Clinic/Center 261QH0100X
License
19856 (MO)
Legal business name
GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION
Practice address
130 E Lockling St
Brookfield, MO 64628-2337
Phone
(660) 258-1050
Fax
(660) 258-1052
NPI assigned
May 5, 2016
Organization subpart
No

Authorized official

Name
Mr. Kenneth E Baranski
Title
Cfo
Phone
(660) 258-1288

Corporate family (same tax ID) 7

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

National Provider Directory

Tax ID family
General John J Association (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 19856 MO Yes

Addresses

Primary practice location

130 E Lockling St
Brookfield, MO 64628-2337

Mailing address

125 E Lockling St
Brookfield, MO 64628-2367
Phone (660) 258-1307

Other identifiers

IdentifierTypeStateIssuer
503898603MedicaidMO
596059501MedicaidMO

Other names

  • Community Medical Associates Doing business as

Other providers in Brookfield, MO

All providers in Brookfield, MO · Health Service Clinic/Center in Missouri

Sources for this page

Verify at the official NPI Registry.