NPIMap

Organization Active NPI

Poplar Bluff Regional Medical Center Inc

Doing business as Poplar Bluff Regional Medical Center Home Health Services

  • Home Health Agency
  • Poplar Bluff, MO
National Provider Identifier
1962408187
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
751-1 Issued in MO
Legal business name
POPLAR BLUFF REGIONAL MEDICAL CENTER INC
Doing business as
Poplar Bluff Regional Medical Center Home Health Services
Practice address
621 W Pine St
Poplar Bluff, MO 63901-5042
Phone
(573) 686-8144
Fax
(573) 686-8147
NPI assigned
Jun 22, 2005
Last updated
May 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Authorized official

Name
Timothy Parry, ESQ
Title
Sr. VP and General Counsel
Phone
(239) 594-7368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 751-1 MO Primary

Addresses

Primary practice location

621 W Pine St
Poplar Bluff, MO 63901-5042

Mailing address

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396
Phone (573) 686-8144

Other identifiers 1

IdentifierTypeStateIssuer
580420008MedicaidMO

Other names 1

  • Poplar Bluff Regional Medical Center Home Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Poplar Bluff Regional Medical Center Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1962408187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013396",
            "telephone_number": "573-686-8144",
            "fax_number": "573-686-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W PINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015042",
            "telephone_number": "573-686-8144",
            "fax_number": "573-686-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLAR BLUFF REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "PARRY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "SR. VP AND GENERAL COUNSEL",
        "authorized_official_telephone_number": "239-594-7368",
        "authorized_official_credential": "ESQ"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "751-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "580420008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poplar Bluff Regional Medical Center Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.