Provider Demographics
NPI:1285995944
Name:GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:660-258-1288
Mailing Address - Street 1:101 E HAYWARD ST
Mailing Address - Street 2:PO BOX 131
Mailing Address - City:MEADVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64659-9201
Mailing Address - Country:US
Mailing Address - Phone:660-938-4213
Mailing Address - Fax:660-938-4211
Practice Address - Street 1:101 E HAYWARD ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:MO
Practice Address - Zip Code:64659-9201
Practice Address - Country:US
Practice Address - Phone:660-938-4213
Practice Address - Fax:660-938-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health