Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice |
| NPI # | 1467798322 |
| LBN Legal business name | ST MARY'S REGIONAL HEALTH CENTER |
| Authorized official | ALAN HURLEY - (COO) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 12/21/2012 |
| Last updated | 03/01/2024 - About 2 years ago |
| Identifiers | n/a |
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