NPIMap

Organization Active NPI

Pemiscot Memorial Health Systems

  • Pharmacy
  • Hayti, MO
National Provider Identifier
1619019908
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
5045 Issued in MO
Legal business name
PEMISCOT MEMORIAL HEALTH SYSTEMS
Practice address
946 East Reed St.
Hayti, MO 63751-0489
Phone
(573) 359-1372
NPI assigned
Feb 13, 2007
Last updated
Oct 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Authorized official

Name
Kerry Noble
Title
Ceo
Phone
(573) 359-3612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5045 MO Primary

Addresses

Primary practice location

946 East Reed St.
Hayti, MO 63751-0489

Mailing address

PO Box 489
Hayti, MO 63851-0489

National Provider Directory

National Provider Directory
Tax ID family
W O Bryant MD12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1619019908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "638510489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 EAST REED ST.",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "637510489",
            "telephone_number": "573-359-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMISCOT MEMORIAL HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2011-10-24",
        "status": "A",
        "authorized_official_last_name": "NOBLE",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-359-3612"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "5045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayti, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.