CARROLL COUNTY MEMORIAL HOSPITAL (NPI# 1528067113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528067113 |
| Entity Type | Organization |
| Organization Name | CARROLL COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | CARROLL COUNTY MEMORIAL HOSPITAL |
| Practice Address |
1502 N Jefferson St Carrollton MO 64633-1948 |
| Mailing Address |
1502 N Jefferson Carrollton MO 64633-1948 |
| Practice Telephone | 6605421695 |
| Practice Fax Number | 6605420363 |
| Mailing Telephone | 6605421695 |
| Mailing Fax Number | 6605420363 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2013-02-26 |
| Authorized Official Name | JEFF A TINDLE (CEO) |
| Authorized Official Telephone | 6605421695 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 275N00000X | Medicare Defined Swing Bed Unit | MO | Hospital Units | |
| N | 275N00000X | Medicare Defined Swing Bed Unit | 26Z332 | MO | Hospital Units |
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
210-45 | MO | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | CA010157907 | 05 | |
| MO | BCBS | 90017016 | 01 |
| MO | 010157907 | 05 |
| Other Name | Type Code |
|---|---|
| Carroll County Memorial Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972731529 | Carroll County Memorial Hospital | Family Medicine | 1401 N Jefferson St, Carrollton, MO 64633-1945 | 2009-06-22 |
| 1205831013 | Carroll County Memorial Hospital | Home Health | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2005-06-17 |
| 1114135050 | Carroll County Memorial Hospital | Internal Medicine | 1502 N Jefferson St, Suite A B, Carrollton, MO 64633-1948 | 2007-05-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CARROLL COUNTY MEMORIAL HOSPITAL | 309 Eleventh Street, Carrollton, KY 41008-1435 |
| Street Address |
1502 N JEFFERSON ST |
| City | CARROLLTON |
| State | MO |
| Zip Code | 64633-1948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205831013 | Carroll County Memorial Hospital | Home Health | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2005-06-17 |
| 1003441122 | Ess of Carroll County LLC | Emergency Medicine | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2020-03-09 |
| 1649805763 | Hcc of Carroll County LLC | Internal Medicine | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2020-03-09 |
| 1477073328 | Erin Elizabeth Finkeldei | Nurse Practitioner | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2017-06-21 |
| 1700253812 | Jonna Hickcox Rechterman | Nurse Practitioner | 1502 N Jefferson St, Carrollton, MO 64633 | 2015-08-24 |
| 1841625233 | Tanya Waddle Land | Nurse Practitioner | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2013-09-05 |
| 1154678415 | Meritas Health Corporation | Internal Medicine | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2012-08-06 |
| 1720342629 | Andrew Douglas Horine | Family Medicine | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2012-06-26 |
| 1619276367 | Jefferson Medical Group | Clinic/Center | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2011-03-21 |
| 1366752768 | Carroll County Medical Clinic | Family Medicine | 1502 N Jefferson St, St Suite A B, Carrollton, MO 64633-1948 | 2010-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295140572 | B-pharm, Inc | Pharmacy | 1003 Highway 65 North, Suite B, Carrollton, MO 64633 | 2014-06-25 |
| 1023252541 | Pamela Lynn Ralls | Family Medicine | 1502 N.jefferson Street, Ccmh Medical Plaza, Carrollton, MO 64633 | 2009-04-28 |
| 1578733648 | Sloan Eyecare Center L.l.c | Optometrist | 1405 N Jefferson, Carroll County Jefferson Medical Pavillion, Carrollton, MO 64633 | 2008-03-05 |
| 1679616742 | Arlene Capistrano Germann | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Lakeview Ct, Carrollton, MO 64633 | 2007-02-15 |
| 1932110483 | Tori D Waggoner | Pharmacist | 1003 Hwy 65 North, Carrollton, MO 64633 | 2006-08-10 |
| 1376553511 | Gay Lynn Korff | Pharmacist | 1003 Hwy. 65, Carrollton, MO 64633 | 2006-08-09 |
| 1790730182 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1003 N Us Highway 65, Carrollton, MO 64633 | 2006-05-23 |
| 1790097764 | Jodi Dawn Ahnefeld | Pharmacist | 1003 Hwy 65 North, Carrollton, MO 64633 | 2010-07-07 |
| 1770618274 | James Mitchell Germann | Day Training/Habilitation Specialist | 1102 Lakeview Ct, Carrollton, MO 64633 | 2007-02-23 |
| 1205038783 | Carroll County Health Department | Public Health or Welfare | 5 N Ely St, Carrollton, MO 64633-1309 | 2007-06-05 |
| Find all providers in zip 64633 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952557399 | Carroll County Hospital Phtysicians | General Acute Care Hospital | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2008-08-18 |
| 1003030487 | Ccmh Corporation | General Acute Care Hospital | 309 11th St, Carrollton, KY 41008-1435 | 2007-04-13 |
| 1225159601 | Ccmh Corporation | General Acute Care Hospital | 309 11th St, Carrollton, KY 41008-1435 | 2007-04-03 |
| 1811096811 | Thomas H. Boyd Memorial Hospital | General Acute Care Hospital | 800 School St, Carrollton, IL 62016-1436 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356689905 | Southeast Health Center of Reynolds County LLC | General Acute Care Hospital | 100 Hwy 21, Ellington, MO 63638-7943 | 2013-01-16 |
| 1467789222 | Va Medical Center In St.louis | General Acute Care Hospital | 9830 Eastdell Dr, Saint Louis, MO 63136-1915 | 2009-11-14 |
| 1750512042 | Vicky Laurine Simbro | General Acute Care Hospital | 4505 Cove Rd, Osage Beach, MO 65065-2307 | 2009-08-04 |
| 1710177480 | Wisam Hassan Ali Al Badr | General Acute Care Hospital | 3635 Grand Blvd, Saint Louis, MO 63110-2539 | 2007-07-30 |
| 1619179561 | Saint Louis University Medical Center | General Acute Care Hospital | 1402 S Grand Blvd # M238, Saint Louis, MO 63104-1004 | 2007-06-04 |
| 1962578609 | Hermann Area Hospital District | General Acute Care Hospital | 509 West 18th St, Hermann, MO 65041 | 2006-11-27 |
| 1477648178 | Iron County Hospital District | General Acute Care Hospital | 301 N Highway 21, Pilot Knob, MO 63663-0548 | 2006-10-04 |
| 1023053477 | Mercy St. Francis Hospital | General Acute Care Hospital | 100 West Highway 60, Mountain View, MO 65548 | 2006-06-19 |
| 1912948308 | Saint Lukes Hospital of Chillicothe | General Acute Care Hospital | 2799 N Washington, Chillicothe, MO 64601-2902 | 2006-06-09 |
| 1720039605 | Cedar County Memorial Hospital | General Acute Care Hospital | 1401 S Park St, El Dorado Springs, MO 64744-2037 | 2006-05-15 |
| Find all providers with the same taxonomy | ||||
| City | CARROLLTON |
| Zip Code | 64633 |
Please comment or provide details below to improve the information on CARROLL COUNTY MEMORIAL HOSPITAL.
| 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.