1629295456 NPI number — CITY OF BELTON

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629295456 NPI number — CITY OF BELTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF BELTON
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:
1629295456
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
506 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64012-2618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-331-4331
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16300 N MULLEN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64012-2618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-331-4331
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ERNZEN
Authorized Official First Name:
SHEILA
Authorized Official Middle Name:
ERNZEN
Authorized Official Title or Position:
ASST. CITY MANAGER AND FINANCE DIRE
Authorized Official Telephone Number:
816-331-4331

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  037010 , 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: 800461709 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 826590044 . This is a "PALMETTO GBA RAILROAD" identifier . This identifiers is of the category "OTHER".




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