Fulton State Hospital

LBN: State Of Missouri
Fulton State Hospital is an health care organization with primary practice located at 600 E 5Th St , Fulton MO 65251-1753. The organization recently has only one registered license in Hospitals / Psychiatric Hospital, which is considered as the primary health care specialty. State Of Missouri can be contacted via phone (573) 592-4100, or through Boeckmann, Molly Jane via phone (573) 751-4055.

Contact Information

Primary practice address
600 E 5Th St Fulton MO 65251-1753
Phone: (573) 592-4100
Fax: (573) 592-3100
Website:
Map and Directions
Authorized official contact:
Name: Boeckmann, Molly Jane
Phone: (573) 751-4055

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Psychiatric Hospital 283Q00000X EXEMPT Missouri

Profile Details

NPI number 1104878792
LBN Legal business name State Of Missouri
DBA Doing business as Fulton State Hospital
Authorized official Boeckmann, Molly Jane
Entity Organization
Organization subpart 1 Yes
Enumeration date May 16th, 2006
Last updated Aug 31st, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104878792 NPPES
Missouri MEDICAID 050490002

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