Provider Demographics
NPI:1659675536
Name:PIGGOTT COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:PIGGOTT COMMUNITY HOSPITAL
Other - Org Name:CAMPBELL HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-598-3881
Mailing Address - Street 1:115 N ASH ST
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:MO
Mailing Address - Zip Code:63933-1505
Mailing Address - Country:US
Mailing Address - Phone:573-246-2882
Mailing Address - Fax:573-246-2122
Practice Address - Street 1:115 N ASH ST
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:MO
Practice Address - Zip Code:63933-1505
Practice Address - Country:US
Practice Address - Phone:873-246-2882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO196-20251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO581359908Medicaid
MO196-20OtherMO LICENSE NUMBER