Provider Demographics
NPI:1346533569
Name:MCCUNE BROOKS HOSPITAL
Entity type:Organization
Organization Name:MCCUNE BROOKS HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:Y
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-358-8121
Mailing Address - Street 1:1515 HAZEL ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-2850
Mailing Address - Country:US
Mailing Address - Phone:417-237-0983
Mailing Address - Fax:417-237-0997
Practice Address - Street 1:1515 HAZEL ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-2850
Practice Address - Country:US
Practice Address - Phone:417-237-0983
Practice Address - Fax:417-237-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health