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Citizens Memorial Healthcare

Organization Active NPI Ophthalmology Physician · Bolivar, MO

NPI 1891909552 · NPPES record last updated Mar 27, 2014

Key facts

NPI
1891909552
Entity type
Organization (NPI type 2)
Primary specialty
Ophthalmology Physician 207W00000X
Legal business name
CITIZENS MEMORIAL HEALTHCARE
Practice address
1155 W. Parkview St.
Suite 1 B
Bolivar, MO 65613-7800
Phone
(417) 777-2222
Fax
(417) 777-2224
NPI assigned
May 10, 2007
Organization subpart
Yes
Parent organization (as reported)
CITIZENS MEMORIAL HEALTHCARE

Authorized official

Name
Dona Gillispie
Title
Administrative Assistant
Phone
(417) 328-7243

Corporate family (same tax ID) 18

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

National Provider Directory

Tax ID family
Citizens Memorial Healthcare (19 organizations share this tax ID)
Part of
Citizens Memorial Healthcare

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207W00000X Yes

Addresses

Primary practice location

1155 W. Parkview St.
Suite 1 B
Bolivar, MO 65613-7800

Mailing address

1155 W. Parkview St.
Suite 1 B
Bolivar, MO 65613-7800
Phone (417) 777-2222

Other identifiers

IdentifierTypeStateIssuer
506997907MedicaidMO

Other names

  • CMH Eye Specialty Center Doing business as

Other providers in Bolivar, MO

All providers in Bolivar, MO · Ophthalmology Physician in Missouri

Sources for this page

Verify at the official NPI Registry.