Basic Information
| Provider Information | |||||||||
| NPI: | 1770536740 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BATES COUNTY MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 19793 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6602007000 | ||||||||
| FaxNumber: | 6602007004 | ||||||||
| Practice Location | |||||||||
| Address1: | 615 W NURSERY ST | ||||||||
| Address2: | |||||||||
| City: | BUTLER | ||||||||
| State: | MO | ||||||||
| PostalCode: | 647301840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6602007000 | ||||||||
| FaxNumber: | 6602007004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| AuthorizedOfficialLastName: | WEAVER | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6602007000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 268646 | MO | N | Ambulatory Health Care Facilities | Clinic/Center | 261Q00000X | 268606 | MO | N | Ambulatory Health Care Facilities | Clinic/Center | 261Q00000X | 268639 | MO | N | Ambulatory Health Care Facilities | Clinic/Center | 261QR1300X | 268606 | MO | N | Ambulatory Health Care Facilities | Clinic/Center | Rural Health | 261QR1300X | 268646 | MO | N | Ambulatory Health Care Facilities | Clinic/Center | Rural Health | 261QR1300X | 268639 | MO | N | Ambulatory Health Care Facilities | Clinic/Center | Rural Health | 282N00000X | 205 45 | MO | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 540673605 | 05 | MO | MEDICAID | 00125012 | 01 | MO | KC BC/BS | OTHER | 010673606 | 05 | MO | MEDICAID | 90012015 | 01 | MO | KC BC/BS | OTHER | 0927601 | 01 | MO | KC BC/BS | OTHER | 588185306 | 05 | MO | MEDICAID | 800673618 | 05 | MO | MEDICAID | 8030343401 | 05 | KS | MEDICAID |