Provider Demographics
NPI:1043544695
Name:HANNIBAL REGIONAL HEALTH CARE SYSTEM
Entity type:Organization
Organization Name:HANNIBAL REGIONAL HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:GASAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-406-1608
Mailing Address - Street 1:6500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-6890
Mailing Address - Country:US
Mailing Address - Phone:573-248-1300
Mailing Address - Fax:
Practice Address - Street 1:400 S CENTER ST
Practice Address - Street 2:
Practice Address - City:SHELBINA
Practice Address - State:MO
Practice Address - Zip Code:63468-1404
Practice Address - Country:US
Practice Address - Phone:573-588-4131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO083630261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service