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Contact Information

BOONVILLE NO 1 INC
1450 W ASHLEY RD
BOONVILLE, MO65233
 Phone: 660-882-7007
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for BOONVILLE NO 1 INC

NPI # 1295767275
LBN Legal business name BOONVILLE NO 1 INC
Authorized official DONALD BEDELL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/07/2006
Last updated 06/19/2018 - About 8 years ago
Identifiers
MO License # 046405
MO Medicaid 101777001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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