MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME (NPI# 1003983859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003983859 |
| Entity Type | Organization |
| Organization Name | MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME |
| Other Organization Name | MADISON MEDICAL CENTER |
| Practice Address |
611 West Main Street Fredericktown MO 63645 |
| Mailing Address |
Po Box 431 611 West Main Street Fredericktown MO 63645 |
| Practice Telephone | 5737833341 |
| Practice Fax Number | 5737831096 |
| Mailing Telephone | 5737833341 |
| Mailing Fax Number | 5737831096 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. LISA MARIE TWIDWELL (CFO) |
| Authorized Official Telephone | 5737833341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Madison Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225104045 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Homemaker | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1851467674 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Technician | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1306912134 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Ambulance | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| Street Address |
611 WEST MAIN STREET |
| City | FREDERICKTOWN |
| State | MO |
| Zip Code | 63645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467539031 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-01 |
| 1235392309 | Humberto Jose Olivero Lara | Family Medicine | 611 West Main Street, Fredericktown, MO 63645 | 2008-07-08 |
| 1043490857 | Julie Marie Buford | Nurse Practitioner | 611 West Main Street, Suite E, Fredericktown, MO 63645-1111 | 2007-11-08 |
| 1750457586 | Madison Medical Center Stockhoff Memorial Nursing Home | Home Health | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1316013139 | Madison Medical Center Stockhoff Memorial Nursing Home | Medicare Defined Swing Bed Unit | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1225104045 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Homemaker | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1851467674 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Technician | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1306912134 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Ambulance | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1215003041 | Madison Medical Center Stockhoff Memorial Nursing Home | Nursing Facility/Intermediate Care Facility | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193880 | Emily Engers | Counselor | 206 W Marvin Ave, Fredericktown, MO 63645 | 2015-05-12 |
| 1871823955 | Covenant Care Services, LLC | Custodial Care Facility | 1610 W. Hwy 72, Fredericktown, MO 63645 | 2010-01-12 |
| 1518110279 | East Missouri Action Agency, Inc. | Clinic/Center | 806 West College Rd, Fredericktown, MO 63645 | 2008-10-28 |
| 1679737324 | Linda Carole Cravens | Dentist | 731 W Main St, Guy A Walker Dds, Fredericktown, MO 63645 | 2008-07-11 |
| 1629286976 | Community Health Care Associates, Inc | Social Worker | 735 West Main, Fredericktown, MO 63645 | 2007-05-18 |
| 1487749537 | Covenant Care Services, LLC | Registered Nurse | 120 S. Mine Lamotte, Fredericktown, MO 63645 | 2006-10-04 |
| 1215577945 | Modern Mental Health | Community/Behavioral Health | 151 South Main Street, Suite B, Fredericktown, MO 63645 | 2020-01-10 |
| 1619081593 | Angela R Menz | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645 | 2006-08-18 |
| 1811439227 | Bali Rae Hoover-richardson | Counselor | 1800 County Road 257, Fredericktown, MO 63645-0025 | 2016-11-16 |
| 1154673887 | Wagner Residential Care Inc | Assisted Living Facility | 320 N Chamber Dr, Fredericktown, MO 63645-0320 | 2012-10-04 |
| Find all providers in zip 63645 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346316007 | Town & Country Grocers of Fredericktown Mo Inc | Pharmacy | 210 E Murta St, Fredericktown, MO 63645-1018 | 2006-11-27 |
| 1053764571 | Parkland Pharmacy Development LLC | Pharmacy | 1025 E Highway 72 Byp, Fredericktown, MO 63645-7326 | 2016-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912506437 | E Health Pharmacy, LLC | Pharmacy | 411d Northview Rd, Nixa, MO 65714-8679 | 2020-10-26 |
| 1750994869 | Script Partner Pharmacy LLC | Pharmacy | 100 Chesterfield Bus Pkwy Ste 279, Chesterfield, MO 63005-1271 | 2020-08-28 |
| 1821600545 | Debbie S Pharmacy LLC | Pharmacy | 815 Hazelwest Dr Ste 100, Hazelwood, MO 63042-1762 | 2020-08-24 |
| 1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
| 1023626389 | Lemonaid Community Pharmacy, Inc | Pharmacy | 7580 Watson Rd, Saint Louis, MO 63119-4409 | 2020-07-22 |
| 1689207870 | Washington University Cancer Center Pharmacy - North County | Pharmacy | 1225 Graham Rd Fl 1, Florissant, MO 63031-8012 | 2020-02-17 |
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1720624323 | Toney Drug & Wellness, LLC | Pharmacy | #1 Hals Plaza Dr, Piedmont, MO 63957 | 2019-11-19 |
| 1427606912 | Medley Pharmacy Inc | Pharmacy | 1024 S Bishop Ave, Rolla, MO 65401-4416 | 2019-08-28 |
| 1013479716 | Cerner Health Connections, Inc. | Pharmacy | 1403 Hampton Avenue, St. Louis, MO 63139 | 2019-04-02 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKTOWN |
| Zip Code | 63645 |
Please comment or provide details below to improve the information on MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME.
| 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.