1588665020 NPI number — RESOURCE CENTER FOR GYNECOLOGIC ONCOLOGY L.L.C.

Table of content: (NPI 1588665020)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588665020 NPI number — RESOURCE CENTER FOR GYNECOLOGIC ONCOLOGY L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESOURCE CENTER FOR GYNECOLOGIC ONCOLOGY L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588665020
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 801606
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64180-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-234-1350
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6400 PROSPECT AVE
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64132-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-926-0777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HUNTER
Authorized Official First Name:
VERDA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
816-926-0777

Provider Taxonomy Codes

  • Taxonomy code: 207VX0201X , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 26042018 . This is a "BCBS KC MO" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 100362880A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 505343707 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: CH5536 . This is a "RR MCR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com