Ccmh Family Health Clinic

LBN: Cooper County Memorial Hospital
Ccmh Family Health Clinic is an health care organization with primary practice located at 600 W Morrison St Suite 5, Fayette MO 65248-1075. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Cooper County Memorial Hospital can be contacted via phone (660) 248-2900, or through Gearhart, Danielle via phone (660) 882-7461.

Contact Information

Primary practice address
600 W Morrison St Suite 5 Fayette MO 65248-1075
Phone: (660) 248-2900
Fax: (660) 248-1544
Website:
Map and Directions
Authorized official contact:
Name: Gearhart, Danielle
Phone: (660) 882-7461

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1871626234
LBN Legal business name Cooper County Memorial Hospital
DBA Doing business as Ccmh Family Health Clinic
Authorized official Gearhart, Danielle
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2007
Last updated Jul 25th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871626234 NPPES
Missouri MEDICAID 590328506
Missouri Other 26-3483

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