ME'TIS BREAST CARE (STE GENEVIEVE COUNTY MEMORIAL HOSPITAL) NPI 1295030807

Clinic/Center (Medical Specialty) in Ste Genevieve, MO

NPI 1295030807 Organization Clinic/Center Medical Specialty

About ME'TIS BREAST CARE (STE GENEVIEVE COUNTY MEMORIAL HOSPITAL)

Me'tis Breast Care (ste Genevieve County Memorial Hospital) is a provider established in Ste Genevieve, Missouri specializing in clinic/center (medical specialty) . The NPI number of Me'tis Breast Care (ste Genevieve County Memorial Hospital) is 1295030807 and was assigned on January 2011. The practitioner's primary taxonomy code is 261QM2500X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Me'tis Breast Care. The authorized official of this NPI record is Jon Branstetter (Cfo)

NPI

1295030807

Provider NameME'TIS BREAST CARE (STE GENEVIEVE COUNTY MEMORIAL HOSPITAL)
Provider Location Address120 PLAZA DR STE GENEVIEVE, MO 63670
Provider Mailing Address120 PLAZA DR STE GENEVIEVE, MO 63670
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameME'TIS BREAST CARE
Other Name TypeDoing Business As (3)
Enumeration Date01-13-2011
Last Update Date09-09-2020


Primary Taxonomy

Taxonomy Code261QM2500X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationMedical Specialty
Taxonomy DescriptionAn entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Business Address

ME'TIS BREAST CARE
120 PLAZA DR
STE GENEVIEVE, MO
ZIP 63670
Phone: (573) 883-2782
Fax: (573) 883-3684

Get Directions


Mailing Address

ME'TIS BREAST CARE
120 PLAZA DR
STE GENEVIEVE, MO
ZIP 63670
Phone: (573) 883-5717
Fax: (573) 883-3684



Authorized Official

Authorized Official Name JON BRANSTETTER
Authorized Official TitleCFO
Authorized Official Phone(573) 883-7714

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
504887308MEDICAID (05)MO
CC8331OTHER (01)MO

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1154871143STE GENEVIEVE COUNTY MEMORIAL HOSPITAL
Organization
Clinic/Center (Rural Health)120 PLAZA DR
STE GENEVIEVE, MO 63670
(573) 883-1199

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.