Provider Demographics
NPI:1033458435
Name:N & R OF NORTH COLUMBIA LLC
Entity type:Organization
Organization Name:N & R OF NORTH COLUMBIA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:573-481-9625
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-1559
Mailing Address - Country:US
Mailing Address - Phone:573-481-9625
Mailing Address - Fax:573-481-0773
Practice Address - Street 1:701 BLUE RIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-3734
Practice Address - Country:US
Practice Address - Phone:573-474-6111
Practice Address - Fax:573-474-0680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO040882314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101484400Medicaid
MO265251Medicare Oscar/Certification