Provider Demographics
NPI:1396379830
Name:GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-885-8171
Mailing Address - Street 1:603 E GAINES DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MO
Mailing Address - Zip Code:64735-3205
Mailing Address - Country:US
Mailing Address - Phone:660-885-5511
Mailing Address - Fax:
Practice Address - Street 1:603 E GAINES DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MO
Practice Address - Zip Code:64735-3205
Practice Address - Country:US
Practice Address - Phone:660-885-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center