SAMUEL & JILL HIERONYMUS


Address: 507 E Marshall St, Sweet Springs, MO 65351-9759
Phone: 6603356500

SAMUEL & JILL HIERONYMUS (NPI# 1134341647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134341647
Entity Type Organization
Organization Name SAMUEL & JILL HIERONYMUS
Other Organization Name ROYAL OAKS RESIDENCE
Practice Address 507 E Marshall St
Sweet Springs
MO 65351-9759
Mailing Address 507 E Marshall St
Po Box 204
Sweet Springs
MO 65351-9759
Practice Telephone 6603356500
Practice Fax Number 6603356656
Mailing Telephone 6603356500
Mailing Fax Number 6603356656
Enumeration Date 2007-05-03
Last Update Date 2015-04-02
Authorized Official Name MRS. JILL HIERONYMUS (OWNER)
Authorized Official Telephone 6603356500
Authorized Official Credential RN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 310400000X Assisted Living Facility 033834 MO Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
Royal Oaks Residence Doing Business As Name - Organization

Office Location

Street Address 507 E MARSHALL ST
City SWEET SPRINGS
State MO
Zip Code 65351-9759

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1699088278 Debra Lorene Koch Nurse Practitioner 105 Hostpital Drive, Sweet Springs, MO 65351 2010-07-23
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1184864779 Cah Acquisition Company 6 LLC Medicare Defined Swing Bed Unit 105 Hospital Drive, Sweet Springs, MO 65351 2009-02-23
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1528234879 Rhonda Jill Hieronymus Dietary Manager 405 S Locust St, Sweet Springs, MO 65351-1308 2008-05-07
1457436743 Sweet Springs Pharmacy Inc Pharmacy 401 S Locust St, Sweet Springs, MO 65351-1308 2006-10-26
1497300396 Sweet Springs Pharmacy Inc Pharmacy 401 S Locust St, Sweet Springs, MO 65351-1308 2019-08-07
1619198827 Ronald L Hinton Dentist 305 S Miller St, Sweet Springs, MO 65351-1345 2007-05-02
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Taxonomy Information

Taxonomy Code 310400000X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility

Taxonomy Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Notes: [7/1/2003: new]

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Competitor

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City SWEET SPRINGS
Zip Code 65351

Improve Information

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Dataset Information

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.

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