Hayti Medical Clinic, Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

HAYTI MEDICAL CLINIC, INC

Doing business as

Extended Health Systems Medical Clinic

Practice address

1502 Ward Ave
Caruthersville, MO 63830-2571

Phone

(573) 333-4244

Fax

(573) 333-4551

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Glenn Haynes

Title

Ceo

Phone

(573) 359-2930

Specialties & licenses 1

Addresses

Other names 1

• Extended Health Systems Medical Clinic Doing business as

Tax ID family

Ehs Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Hayti Medical Clinic, Inc

  • Primary Care Clinic/Center
  • Hayti, MO
  • NPI 1982723375
  NPD tax ID

Locations

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851373906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "638510037",
            "telephone_number": "573-359-2930",
            "fax_number": "573-359-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 WARD AVE",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638302571",
            "telephone_number": "573-333-4244",
            "fax_number": "573-333-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYTI MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-359-2930"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Extended Health Systems Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tondra Harris
• Julie Ann Harrison
• Angela G Hatch
• Hayden Drug Company, Inc.
• Henry Thomas Hayden, R.PH.
• Briana Lynn Hilburn
• Wendy Hollywood
• Hannah Hopper
• Matthew Hoskins
• Adeline Hubbard, DDS

• Rural Health Clinic/Center in Caruthersville, MO
• Providers in Caruthersville, MO by specialty
• Rural Health Clinic/Center in Missouri

• 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.