TEXAS COUNTY MEMORIAL HOSPITAL (NPI# 1235178930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235178930 |
| Entity Type | Organization |
| Organization Name | TEXAS COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | TCMH FAMILY CLINIC - LICKING |
| Practice Address |
Main & Myers Licking MO 65542-9027 |
| Mailing Address |
Main & Myers Po Box 47 Licking MO 65542-9027 |
| Practice Telephone | 5736743011 |
| Practice Fax Number | 5736744765 |
| Mailing Telephone | 5736743011 |
| Mailing Fax Number | 5736744765 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-06-20 |
| Authorized Official Name | MRS. LINDA J. PAMPERIEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4179673311 |
| Is Organization Subpart | Y |
| Parent Organization Name | TEXAS COUNTY MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | CLIA | 26D0679044 | 01 |
| MO | 505288902 | 05 |
| Other Name | Type Code |
|---|---|
| TCMH Family Clinic - Licking | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921300 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd Ste A, Houston, MO 65483 | 2018-02-02 |
| 1265754501 | Texas County Memorial Hospital | Clinic/Center | 1905 West 19th Street, Mountain Grove, MO 65711 | 2010-02-26 |
| 1164587770 | Texas County Memorial Hospital | Pharmacy | 1422 S Sam Houston Blvd Ste 100, Houston, MO 65483 | 2006-12-26 |
| 1538108253 | Texas County Memorial Hospital | Clinic/Center | 805 2nd St, Summersville, MO 65571-8714 | 2006-06-06 |
| 1235176256 | Texas County Memorial Hospital | Clinic/Center | 1335 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-05-31 |
| 1093780678 | Texas County Memorial Hospital | Hospice Care, Community Based | 1422 S Sam Houston Blvd Ste 300, Houston, MO 65483-2119 | 2006-02-17 |
| 1356324727 | Texas County Memorial Hospital | Home Health | 1422 S Sam Houston Blvd Ste 200, Houston, MO 65483 | 2005-11-21 |
| 1093286619 | Texas County Memorial Hospital | Clinic/Center | 1422 S Sam Houston Blvd, Houston, MO 65483-2130 | 2018-12-07 |
| 1548731169 | Texas County Memorial Hospital | Clinic/Center | 1422 S Sam Houston Blvd, Houston, MO 65483-2130 | 2018-12-07 |
| 1285957001 | Texas County Memorial Hospital | Clinic/Center | 1905 West 19th Street, Mountain Grove, MO 65711 | 2010-03-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TEXAS COUNTY MEMORIAL HOSPITAL HEALTHCARE FOUNDATION | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 |
| Street Address |
MAIN & MYERS |
| City | LICKING |
| State | MO |
| Zip Code | 65542-9027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154766806 | Arlene J O'brien | Counselor | 15423 Mccloy Road, Licking, MO 65542 | 2013-05-08 |
| 1629639109 | Douglas County Public Health Services Group, Inc. | Family Medicine | 135 College Ave., Licking, MO 65542 | 2019-06-25 |
| 1487171930 | Mercy Pharmacy Services, LLC | Pharmacy | 101 N Main St, Po Box 125, Licking, MO 65542 | 2017-08-25 |
| 1912424607 | Licking No 1 LLC | Skilled Nursing Facility | 209 Hickory St, Licking, MO 65542 | 2017-08-24 |
| 1295115236 | Douglas A Crase | Family Medicine | 233 S Main St, Licking, MO 65542 | 2015-06-04 |
| 1447412770 | Texas County Memorial Hospital | Clinic/Center | 233 South Main Street, Licking, MO 65542 | 2008-06-27 |
| 1336336205 | Russell Mahmudul Huq | Emergency Medicine | 233 S Main St, Licking, MO 65542 | 2007-09-25 |
| 1790978765 | St. John's Physician & Clinic | Pharmacist | 101 North Main Street, Licking, MO 65542 | 2007-08-23 |
| 1457597924 | Natalie Martha Jeffery | Registered Nurse | 135 College Ave., Licking, MO 65542-0000 | 2009-01-05 |
| 1184600181 | Jeffrey Kenneth Blue | Physician Assistant | 233 S Main Street, Licking, MO 65542-0047 | 2005-12-21 |
| Find all providers in zip 65542 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145668 | Essential Benefit Offerings, LLC | Clinic/Center | 1417 N Mount Auburn Rd Ste A2, Cape Girardeau, MO 63701-2171 | 2020-05-07 |
| 1114483468 | Your Optimal Healthcare LLC | Clinic/Center | 300 W 4th St Ste H, Eureka, MO 63025-1839 | 2019-02-12 |
| 1306313051 | Country Care Family Clinic, LLC | Clinic/Center | 3 E Cleveland Ave, Ellsinore, MO 63937 | 2018-10-31 |
| 1285118950 | Vera Whole Health, Wa PC | Clinic/Center | 8350 N. Church Road, Kansas City, MO 64158 | 2018-09-19 |
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1093267601 | Careatc-saint Peter | Clinic/Center | 4601 Executive Centre Pkwy, Saint Peters, MO 63376-1683 | 2016-10-30 |
| 1407303480 | Kerns Family Health Care LLC | Clinic/Center | 1335 Vilage Dr B, St. Joseph, MO 64506-2457 | 2016-09-07 |
| 1316491020 | Wecare Tlc - Wwt Mo Family Health Center | Clinic/Center | 58 Weldon Pkwy, Bldg 58, Maryland Heights, MO 63043-3237 | 2016-08-10 |
| 1255703500 | Community Hospital Association | Clinic/Center | 101 South Washington Street, Oregon, MO 64473 | 2015-10-27 |
| 1023485752 | Dennis E. Robinson D.o. | Clinic/Center | 487 Pomme De Terre Dr., Marshfield, MO 65706 | 2015-08-28 |
| 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.