Pike County Memorial Hospital

Organization Active NPI Family Medicine Physician · Vandalia, MO

NPI 1891201331 · NPPES record last updated Dec 20, 2017

Key facts

NPI
1891201331
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
PIKE COUNTY MEMORIAL HOSPITAL
Practice address
425 N Galloway Rd
Vandalia, MO 63382-1259
Phone
(573) 594-2111
NPI assigned
Dec 20, 2017
Organization subpart
No

Authorized official

Name
Justin Selle
Title
Ceo
Phone
(573) 754-5531

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
Pike County Memorial Ho (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

425 N Galloway Rd
Vandalia, MO 63382-1259

Mailing address

2305 Georgia St
Louisiana, MO 63353-2559
Phone (573) 754-5531

Other names

  • PCMH Clinic Doing business as

Other providers in Vandalia, MO

All providers in Vandalia, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.