Provider Demographics
NPI:1144605312
Name:NEVADA CITY HOSPITAL
Entity Type:Organization
Organization Name:NEVADA CITY HOSPITAL
Other - Org Name:NEVADA REGIONAL MEDICAL CENTER PRIMARY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-448-3626
Mailing Address - Street 1:800 S ASH ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3223
Mailing Address - Country:US
Mailing Address - Phone:417-667-3355
Mailing Address - Fax:417-448-3848
Practice Address - Street 1:627 S ASH ST STE B
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772
Practice Address - Country:US
Practice Address - Phone:417-448-3600
Practice Address - Fax:417-667-2256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA CITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-29
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO190-56261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health