Provider Demographics
NPI:1215358882
Name:HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT
Other - Org Name:HARRISON COUNTY FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-425-2211
Mailing Address - Street 1:2703 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:MO
Mailing Address - Zip Code:64424-2704
Mailing Address - Country:US
Mailing Address - Phone:660-425-7443
Mailing Address - Fax:660-425-6516
Practice Address - Street 1:2703 MILLER ST
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:MO
Practice Address - Zip Code:64424-2704
Practice Address - Country:US
Practice Address - Phone:660-425-7443
Practice Address - Fax:660-425-6516
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-26
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty