Provider Demographics
NPI:1679648661
Name:HERMANN AREA HOSPITAL DISTRICT
Entity type:Organization
Organization Name:HERMANN AREA HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
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
MO238-39282NC0060X
275N00000X
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