Provider Demographics
NPI:1225027642
Name:KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Entity Type:Organization
Organization Name:KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Other - Org Name:MISSOURI'S CHOICE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR DIRECTOR BUSINESS OFFICE SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:2412A S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4616
Mailing Address - Country:US
Mailing Address - Phone:660-627-2787
Mailing Address - Fax:660-627-7492
Practice Address - Street 1:2412A S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-4616
Practice Address - Country:US
Practice Address - Phone:660-627-2787
Practice Address - Fax:660-627-7492
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-18
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO704-9HH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO68OtherBLUE CROSS/BLUE SHIELD
MO580420602Medicaid
MO2899261OtherAETNA HMO
MO320584OtherHEALTHLINK
MO5483002OtherAETNA PPO
MO267296Medicare Oscar/Certification