Basic Information
| Provider Information | |||||||||
| NPI: | 1295092419 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOBERLY HOSPITAL COMPANY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 N MORLEY ST | ||||||||
| Address2: | STE G/H | ||||||||
| City: | MOBERLY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652702334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6602638400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 N MORLEY ST | ||||||||
| Address2: | STE G/H | ||||||||
| City: | MOBERLY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652702334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6602638400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2012 | ||||||||
| LastUpdateDate: | 08/24/2017 | ||||||||
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| AuthorizedOfficialLastName: | LALOR | ||||||||
| AuthorizedOfficialFirstName: | PAULA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR/DELEGATED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 6159254565 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MOBERLY HOSPITAL COMPANY LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.