Provider Demographics
NPI:1316275985
Name:NRMC WOUND CLINIC
Entity type:Organization
Organization Name:NRMC WOUND CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-448-3711
Mailing Address - Street 1:800 S ASH ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3223
Mailing Address - Country:US
Mailing Address - Phone:417-667-3355
Mailing Address - Fax:417-448-3796
Practice Address - Street 1:800 S ASH ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-3223
Practice Address - Country:US
Practice Address - Phone:417-667-3355
Practice Address - Fax:417-448-3796
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA CITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-19
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO190-50282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital