National Provider Identifier Database

CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Hospice Care, Community Based


Contact Information

CITIZENS MEMORIAL HEALTH CARE FOUNDATION
111 W BROADWAY ST
BOLIVAR, MO65613-1501
Phone: 417-328-6350
Fax: 417-328-6987
Website:
Specialty Taxonomy Code
* Hospice Care, Community Based 251G00000X

* Indicates primary specialty

NPI Profile & details for CITIZENS MEMORIAL HEALTH CARE FOUNDATION

NPI Number 1124157169
Legal business name
LBN
CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Authorized official GARY FULBRIGHT - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 03/05/2007
Last updated 02/18/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 003-10H0

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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