Provider Demographics
NPI:1245220052
Name:RAY COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:RAY COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOEMKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-470-5432
Mailing Address - Street 1:904 WOLLARD BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MO
Mailing Address - Zip Code:64085-2229
Mailing Address - Country:US
Mailing Address - Phone:816-470-5432
Mailing Address - Fax:816-470-8382
Practice Address - Street 1:904 WOLLARD BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-2229
Practice Address - Country:US
Practice Address - Phone:816-470-5432
Practice Address - Fax:816-470-8382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
01514018OtherBLUE CROSS-1500
90267015OtherSNF
114311OtherPREFERRED CARE HEALTHLINK
MO010491702Medicaid
MO540491701Medicaid
90052014OtherBLUE CROSS -UB
6350600OtherAETNA
MO7130000Medicare ID - Type UnspecifiedER
MO010491702Medicaid
MO261327Medicare Oscar/Certification