BLACK RIVER COMMUNITY MEDICAL CENTER (NPI# 1548546138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548546138 |
| Entity Type | Organization |
| Organization Name | BLACK RIVER COMMUNITY MEDICAL CENTER |
| Other Organization Name | BLACK RIVER MEDICAL CENTER |
| Practice Address |
217 Physicians Park Drive Poplar Bluff MO 63901-3956 |
| Practice Telephone | 5737279080 |
| Practice Fax Number | 5737780265 |
| Mailing Telephone | 5737279080 |
| Mailing Fax Number | 5737780265 |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2015-11-18 |
| Authorized Official Name | MRS. CHRISTY L SHAWAN (CEO) |
| Authorized Official Telephone | 5736092495 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
MO | Hospitals |
| Other Name | Type Code |
|---|---|
| Black River Medical Center | Doing Business As Name - Organization |
| Street Address |
217 PHYSICIANS PARK DRIVE |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-3956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477891406 | Do Not Use | General Acute Care Hospital | 217 Physicians Park Dr, Poplar Bluff, MO 63901-3956 | 2013-01-25 |
| 1659764595 | John J. Pershing Vamc | General Acute Care Hospital | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2015-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396296893 | Rebekah Christian | General Acute Care Hospital | 39 Mckenzie Rd, High Hill, MO 63350-2907 | 2016-10-19 |
| 1992807952 | Irsa Wood Jackson | General Acute Care Hospital | 12 Willow Brook Dr, Saint Louis, MO 63146-5678 | 2006-09-01 |
| 1598710097 | Cah Acquisition Company 6 LLC | General Acute Care Hospital | 105 Hospital Drive, Sweet Springs, MO 65351-2229 | 2006-05-23 |
| 1427506039 | Phelps County Regional Medical Center | General Acute Care Hospital | 1000 W 10th St, Rolla, MO 65401-2905 | 2016-09-13 |
| 1114379153 | Pemiscot Memorial Health System | General Acute Care Hospital | 946 E Reed St, Hayti, MO 63851-1243 | 2016-07-01 |
| 1205296381 | Excelsior Springs Hospital | General Acute Care Hospital | 1700 Rainbow Blvd, Excelsior Springs, MO 64024-1182 | 2016-03-02 |
| 1902145436 | Ozarks Medical Center | General Acute Care Hospital | 1111 N Kentucky Ave, West Plains, MO 65775-2028 | 2013-02-04 |
| 1487807657 | Cooper County Memorial Hospital | General Acute Care Hospital | 17651 B Hwy, Boonville, MO 65233-2839 | 2008-10-31 |
| 1467663617 | Laurie Steenbergen | General Acute Care Hospital | 1125 Madison St, Jefferson City, MO 65101-5227 | 2007-05-26 |
| 1285844688 | Mercy St John's | General Acute Care Hospital | 331 Hospital Dr Ste D, Lebanon, MO 65536-9251 | 2007-05-23 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
Please comment or provide details below to improve the information on BLACK RIVER COMMUNITY MEDICAL CENTER.
| 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.