Provider Demographics
NPI:1932117173
Name:PARKLAND HEALTH CENTER
Entity Type:Organization
Organization Name:PARKLAND HEALTH CENTER
Other - Org Name:PARKLAND HEALTH CENTER - BONNE TERRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-760-8280
Mailing Address - Street 1:1101 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-1921
Mailing Address - Country:US
Mailing Address - Phone:573-756-6451
Mailing Address - Fax:573-756-1408
Practice Address - Street 1:7245 RAIDER RD
Practice Address - Street 2:
Practice Address - City:BONNE TERRE
Practice Address - State:MO
Practice Address - Zip Code:63628-3767
Practice Address - Country:US
Practice Address - Phone:573-756-6451
Practice Address - Fax:573-756-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO474-3282NC0060X
282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO016028300Medicaid
5020035OtherUNITED HEALTHCARE
856X8562OtherHEALTHCARE USA
119OtherBLUE CROSS-BLUE SHIELD
260163OtherMERCY
182901OtherHEALTH LINK
260163OtherMERCY MC
999681OtherCOMMUNITY CARE PLUS
182901OtherHEALTH LINK
=========OtherAETNA
856X8562OtherHEALTHCARE USA
=========OtherTRICARE
=========OtherGHP