NPIMap

Organization Active NPI

Perry County Health System

Doing business as Perry County Memorial Hospital Home Health Care

  • Home Health Agency
  • Perryville, MO
National Provider Identifier
1942294046
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
651-7 Issued in MO
Legal business name
PERRY COUNTY HEALTH SYSTEM
Doing business as
Perry County Memorial Hospital Home Health Care
Practice address
2 Circle Dr
Perryville, MO 63775-1248
Phone
(573) 547-7133
Fax
(573) 517-0347
NPI assigned
Sep 2, 2005
Last updated
Apr 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Authorized official

Name
Mr. Randy Wolf
Title
Vice President of Finance
Phone
(573) 547-2530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 651-7 MO Primary

Addresses

Primary practice location

2 Circle Dr
Perryville, MO 63775-1248

Mailing address

434 N West St
Perryville, MO 63775-1359
Phone (573) 547-7133

Other identifiers 2

IdentifierTypeStateIssuer
580157204MedicaidMO
123OtherMOBLUE CROSS PROVIDER #

Other names 1

  • PERRY COUNTY MEMORIAL HOSPITAL HOME HEALTH CARE Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1942294046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 N WEST ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751359",
            "telephone_number": "573-547-7133",
            "fax_number": "573-517-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CIRCLE DR",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751248",
            "telephone_number": "573-547-7133",
            "fax_number": "573-517-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY COUNTY HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "573-547-2530",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "651-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "580157204",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "123",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PERRY COUNTY MEMORIAL HOSPITAL HOME HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.