Provider Demographics
NPI:1679648661
Name:HERMANN AREA HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HERMANN AREA HOSPITAL DISTRICT
Other - Org Name:HERMANN AREA DISTRICT HOSPITAL
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 WEST 18TH STREET
Practice Address - Street 2:
Practice Address - City:HERMANN
Practice Address - State:MO
Practice Address - Zip Code:65041
Practice Address - Country:US
Practice Address - Phone:573-486-2191
Practice Address - Fax:573-486-3743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
275N00000X
MO238-39282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO107603OtherHEALTHLINK
MO45827OtherGROUP HEALTH PLAN
MO5020050OtherUNITED HEALTHCARE
MO77OtherBLUE CROSS
MO261314OtherMERCY
MO26-Z314Medicare Oscar/Certification