CITIZENS MEMORIAL HOSPITAL DISTRICT (NPI# 1053712109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053712109 |
| Entity Type | Organization |
| Organization Name | CITIZENS MEMORIAL HOSPITAL DISTRICT |
| Other Organization Name | CITIZENS MEMORIAL OUTPATIENT PHARMACY |
| Practice Address |
1301-b North Oakland Bolivar MO 65613 |
| Mailing Address |
1500 N Oakland Ave Bolivar MO 65613-3011 |
| Practice Telephone | 4173266003 |
| Practice Fax Number | 4177775806 |
| Mailing Telephone | 4173266003 |
| Mailing Fax Number | 4177775806 |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2015-11-09 |
| Authorized Official Name | DONALD BABB (CEO) |
| Authorized Official Telephone | 4173266501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2002031104 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2150441 | 01 |
| Other Name | Type Code |
|---|---|
| Citizens Memorial Outpatient Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619303823 | Citizens Memorial Hospital District | Durable Medical Equipment & Medical Supplies | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2013-09-19 |
| 1932545043 | Citizens Memorial Hospital District | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2013-05-15 |
| 1154598795 | Citizens Memorial Hospital District | Durable Medical Equipment & Medical Supplies | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2008-05-13 |
| 1558548818 | Citizens Memorial Hospital District | Anesthesiology | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2008-01-29 |
| 1003945213 | Citizens Memorial Hospital District | Psychiatric Unit | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2007-03-05 |
| 1841328424 | Citizens Memorial Hospital District | Medicare Defined Swing Bed Unit | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2007-03-02 |
| 1003981549 | Citizens Memorial Hospital District | General Acute Care Hospital | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2006-11-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CITIZENS MEMORIAL HOSPITAL DISTRICT OF POLK COUNTY | 1500 N Oakland Ave, Bolivar, MO 65613-3011 |
| Street Address |
1301-B NORTH OAKLAND |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| 1154761948 | Motor Monkeys LLC | Occupational Therapist | 454 S Main Ave, Bolivar, MO 65613 | 2013-06-26 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467637868 | Walgreen Co | Pharmacy | 1820 S Springfield Ave, Bolivar, MO 65613-2563 | 2008-01-03 |
| 1437160082 | Nuckolls Drug Stores, Inc | Pharmacy | 600 Nuckolls Rd, Bolivar, TN 38008-2393 | 2006-08-10 |
| 1235144148 | The Tamarkin Company | Pharmacy | 11031 State Route 212 Ne, Bolivar, OH 44612-8744 | 2006-07-29 |
| 1730724493 | Hudson Drug Store, LLC | Pharmacy | 600 Nuckolls Rd, Bolivar, TN 38008-1532 | 2019-11-16 |
| 1265878557 | Freds Stores of Tennessee Inc. | Pharmacy | 600 Nuckolls Rd, Bolivar, TN 38008-1532 | 2013-05-14 |
| 1013068220 | Nuckolls Drug Stores, Inc | Pharmacy | 407 W Lafayette St, Bolivar, TN 38008-2651 | 2007-01-15 |
| 1851495451 | Express Save-on Drugs LLC | Pharmacy | 622 W Market St, Bolivar, TN 38008-2241 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374629 | Curators of The University of Missouri | Pharmacy | 7115 East St. Charles Road, Columbia, MO 65202 | 2020-10-21 |
| 1376141143 | Phillips Pharmacy, LLC | Pharmacy | 7278 State Highway 14 E, Sparta, MO 65753-9345 | 2020-10-14 |
| 1013527761 | Rpcs, Inc. | Pharmacy | 18128 State Hwy 13, Branson West, MO 65737 | 2020-08-07 |
| 1205446184 | Rpcs, Inc. | Pharmacy | 200 Southtowne Blvd, Hollister, MO 65672-9610 | 2020-08-05 |
| 1912517897 | Rpcs, Inc. | Pharmacy | 1447 State Highway 248 Ste J, Branson, MO 65616-8161 | 2020-08-05 |
| 1245849801 | Rpcs Inc | Pharmacy | 163 W Old Mill Rd, Fair Grove, MO 65648-7918 | 2020-07-29 |
| 1760005219 | Meta Pharmacy Solutions | Pharmacy | 108 Triad Ctr W, O Fallon, MO 63366-7541 | 2020-05-19 |
| 1437778172 | Harps Food Stores, Inc | Pharmacy | 707 Specialty Dr, Dexter, MO 63841-2718 | 2020-04-13 |
| 1013540038 | Auburn Pharmacy Inc | Pharmacy | 810 W 35th St Ste 101, Higginsville, MO 64037-1865 | 2020-02-18 |
| 1801428495 | Scpg Missouri LLC | Pharmacy | 501 South Madison Ave, Suite S, Webb City, MO 64870 | 2020-02-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.