CITIZENS MEMORIAL HEALTHCARE (NPI# 1407141153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407141153 |
| Entity Type | Organization |
| Organization Name | CITIZENS MEMORIAL HEALTHCARE |
| Other Organization Name | SOUTHSIDE MEDICAL CENTER |
| Practice Address |
1120 S Springfield Ave Bolivar MO 65613-2512 |
| Practice Telephone | 4173266000 |
| Practice Fax Number | 4173264059 |
| Mailing Telephone | 4173267814 |
| Mailing Fax Number | 4173264059 |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2016-09-14 |
| Authorized Official Name | MR. DONALD J BABB (CEO) |
| Authorized Official Telephone | 4173266000 |
| Is Organization Subpart | Y |
| Parent Organization Name | CITIZENS MEMORIAL HOSPITAL DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SOUTHSIDE MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851834659 | Citizens Memorial Healthcare | Clinic/Center | 322 E Hospital Road, El Dorado Springs, MO 64744-2022 | 2016-11-28 |
| 1447464227 | Citizens Memorial Healthcare | Clinic/Center | 1521 3rd Rd, Stockton, MO 65785-9608 | 2007-05-10 |
| 1609080571 | Citizens Memorial Healthcare | Clinic/Center | 201 S Ash St, Buffalo, MO 65622-8674 | 2007-05-10 |
| 1699989350 | Citizens Memorial Healthcare | Clinic/Center | 105 N. Grand St., Suite 2, Greenfield, MO 65661-0367 | 2007-05-10 |
| 1043424708 | Citizens Memorial Healthcare | Clinic/Center | Hwy 254 & Dallas, Hermitage, MO 65668-0125 | 2007-05-10 |
| 1578961454 | Citizens Memorial Healthcare | Clinic/Center | 855 Arduser Dr, Osceola, MO 64776-6278 | 2014-12-09 |
| 1649504309 | Citizens Memorial Healthcare | Clinic/Center | 2230 S Springfield Ave, Suite H-j, Bolivar, MO 65613-9133 | 2009-09-29 |
| 1508070269 | Citizens Memorial Healthcare | Clinic/Center | 201 S Arthur St, Humansville, MO 65674-8400 | 2007-05-10 |
| 1942414610 | Citizens Memorial Healthcare | Clinic/Center | 1195 N Oakland Ave, Suite 2, Bolivar, MO 65613-8095 | 2007-05-10 |
| 1831303502 | Citizens Memorial Healthcare | Clinic/Center | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2007-05-10 |
| Street Address |
1120 S SPRINGFIELD AVE |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-2512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538273396 | Marceleen K. Powell | Nurse Practitioner | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2006-08-18 |
| 1164074175 | Courtney Marie Brummel | Nurse Practitioner | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2019-07-10 |
| 1629268016 | Paul Stephen Stortz | Family Medicine | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2007-07-31 |
| 1316067408 | Bolivar Medical Center, Inc | Clinic/Center | 1120 S Springfield Ave, Bolivar, MO 65613 | 2007-03-30 |
| 1992848139 | Rachael Michelle Swopes | Psychologist | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2007-02-15 |
| 1295802403 | Harcharan Bains | Psychiatry & Neurology | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176667 | The Memorial Hospital of William F and Gertrude F Jones | Clinic/Center | 120 1st St, Bolivar, NY 14715-1132 | 2020-05-21 |
| 1376172866 | Orrville Hospital Foundation | Clinic/Center | 10724 State Route 212 Ne, Bolivar, OH 44612-8740 | 2020-04-06 |
| 1568772481 | Sgoh Acquisition, Inc | Clinic/Center | 910 E San Martin St, Bolivar, MO 65613-2893 | 2010-10-13 |
| 1649504309 | Citizens Memorial Healthcare | Clinic/Center | 2230 S Springfield Ave, Suite H-j, Bolivar, MO 65613-9133 | 2009-09-29 |
| 1316067408 | Bolivar Medical Center, Inc | Clinic/Center | 1120 S Springfield Ave, Bolivar, MO 65613 | 2007-03-30 |
| 1659402006 | Hatchie Clinic P C | Clinic/Center | 640 Nuckolls Rd, Bolivar, TN 38008-1532 | 2007-03-08 |
| 1063588960 | Citizens Memorial Healthcare | Clinic/Center | 1240 N Butterfield Rd, Bolivar, MO 65613-3016 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| Find all providers with the same taxonomy | ||||
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| 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.