Provider Demographics
NPI:1629143698
Name:HERMANN AREA HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HERMANN AREA HOSPITAL DISTRICT
Other - Org Name:HERMANN AREA DISTRICT HOSPITAL HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-486-2191
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:HERMANN
Mailing Address - State:MO
Mailing Address - Zip Code:65041-0470
Mailing Address - Country:US
Mailing Address - Phone:573-486-2191
Mailing Address - Fax:573-486-3743
Practice Address - Street 1:509 W 18TH ST
Practice Address - Street 2:
Practice Address - City:HERMANN
Practice Address - State:MO
Practice Address - Zip Code:65041-1547
Practice Address - Country:US
Practice Address - Phone:573-486-2191
Practice Address - Fax:573-486-3743
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERMANN AREA HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-22
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO189-22251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO8175OtherHEALTHCARE USA
MO261314OtherMERCY
MO580420800OtherMISSOURI CARE
MO107603OtherHEALTHLINK
MO5020050OtherUNITED HEALTHCARE
MO580420800Medicaid
MO45827OtherGROUP HEALTH PLAN
MO77OtherBLUE CROSS
MO107603OtherHEALTHLINK