Provider Demographics
NPI:1124012356
Name:COLUMBIA REGIONAL HOSPITAL - PSYCHIATRIC UNIT
Entity Type:Organization
Organization Name:COLUMBIA REGIONAL HOSPITAL - PSYCHIATRIC UNIT
Other - Org Name:CURATORS OF THE UNIVERSITY OF MISSOURI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE CHANCELLOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-882-4097
Mailing Address - Street 1:121 UNIVERSITY HALL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65211-3020
Mailing Address - Country:US
Mailing Address - Phone:573-884-2640
Mailing Address - Fax:
Practice Address - Street 1:404 KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6626
Practice Address - Country:US
Practice Address - Phone:573-875-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
26S178Medicare ID - Type Unspecified