Provider Demographics
NPI:1245510221
Name:HANNIBAL REGIONAL HOSPITAL
Entity type:Organization
Organization Name:HANNIBAL REGIONAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GRP DIR PATIENT FINANCIAL SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEPPNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-248-5460
Mailing Address - Street 1:6500 HOSPITAL DR
Mailing Address - Street 2:P O BOX 1239
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-6890
Mailing Address - Country:US
Mailing Address - Phone:573-406-5888
Mailing Address - Fax:573-406-5889
Practice Address - Street 1:3650 STARDUST DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-2480
Practice Address - Country:US
Practice Address - Phone:573-231-0660
Practice Address - Fax:573-231-0687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty