SPECIALTY CLINIC AT BLOOMSDALE – NPI #1194075200
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Health Care Provider Taxonomy Code for General Practice

SPECIALTY CLINIC AT BLOOMSDALE is a provider located in BLOOMSDALE, MO. NPPES has assigned the NPI number 1194075200 to SPECIALTY CLINIC AT BLOOMSDALE on September 17, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SPECIALTY CLINIC AT BLOOMSDALE” is a dba name, the actual legal business name for this organization is STE. GENEVIEVE COUNTY MEMORIAL HOSPITAL. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 3 years ago on Jan 13, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SPECIALTY CLINIC AT BLOOMSDALE below.

NPI Profile for
STE. GENEVIEVE COUNTY MEMORIAL HOSPITAL

NPI Number
1194075200
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STE. GENEVIEVE COUNTY MEMORIAL HOSPITAL
Doing Business As (dba): SPECIALTY CLINIC AT BLOOMSDALE
Primary location
255 BODERMAN
SUITE 2A
BLOOMSDALE, MO 63670
Phone: (573) 883-4473 Fax: (573) 883-4472
Mailing address
PO BOX 366
STE GENEVIEVE, MO 63670-0366
Phone: (573) 883-4473 Fax: (573) 883-4472
Organization Subpart
No
Authorized Official
AMANDA WOLK
BUSINESS OFFICE DIRECTOR
Phone: (573) 883-7703
Updated
Certification Date
Jan 13, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.