Basic Information
| Provider Information | |||||||||
| NPI: | 1407046618 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BATES COUNTY MEMORIAL HOSPITAL | ||||||||
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| OtherOrganizationName: | ADRIAN RURAL HEALTH CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 615 W NURSERY ST | ||||||||
| Address2: | PO BOX 370 | ||||||||
| City: | BUTLER | ||||||||
| State: | MO | ||||||||
| PostalCode: | 647301840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6602007108 | ||||||||
| FaxNumber: | 6602007015 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 E. MAIN | ||||||||
| Address2: | |||||||||
| City: | ADRIAN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6602007108 | ||||||||
| FaxNumber: | 6602007015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2007 | ||||||||
| LastUpdateDate: | 08/15/2007 | ||||||||
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| AuthorizedOfficialLastName: | HARRIS | ||||||||
| AuthorizedOfficialFirstName: | WENDELL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6602007001 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | 205-46 | MO | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.