Provider Demographics
NPI:1215221809
Name:MCCUNE BROOKS HOSPITAL
Entity Type:Organization
Organization Name:MCCUNE BROOKS HOSPITAL
Other - Org Name:PHYSICIANS FOR WOMENS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:Y
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-358-8121
Mailing Address - Street 1:1515 HAZEL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-2850
Mailing Address - Country:US
Mailing Address - Phone:417-358-0188
Mailing Address - Fax:417-358-4612
Practice Address - Street 1:1515 HAZEL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-2850
Practice Address - Country:US
Practice Address - Phone:417-358-0188
Practice Address - Fax:417-358-4612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health