Provider Demographics
NPI:1417971953
Name:BOONE HOSPITAL CENTER'S VISITING NURSES, INC.
Entity Type:Organization
Organization Name:BOONE HOSPITAL CENTER'S VISITING NURSES, INC.
Other - Org Name:BOONE HOSPITAL HOME CARE & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-815-3072
Mailing Address - Street 1:1605 E. BROADWAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201
Mailing Address - Country:US
Mailing Address - Phone:573-875-0555
Mailing Address - Fax:573-875-0606
Practice Address - Street 1:1605 E. BROADWAY
Practice Address - Street 2:SUITE 250
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201
Practice Address - Country:US
Practice Address - Phone:573-875-0555
Practice Address - Fax:573-875-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO088-8HO251G00000X
MO088-16HO251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
149839OtherBC/BS OF MO - HOSPICE
MO940562804Medicaid
60-00027OtherUHC
110232OtherHEALTHLINK
18735OtherHEALTHCARE USA
MO580562809Medicaid
MO580562809Medicaid
110232OtherHEALTHLINK