1902197270 NPI number — CHILDRENS MERCY HOSPITAL

Table of content: (NPI 1902197270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902197270 NPI number — CHILDRENS MERCY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDRENS MERCY HOSPITAL
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:
CHILDREN'S MERCY PHARMACY ON BROADWAY
Provider Other Organization Name Type Code:
3
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:
1902197270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2401 GILLHAM RD
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:
64108-4619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-701-5200
Provider Business Mailing Address Fax Number:
816-302-9939

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3101 BROADWAY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64111-2659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-960-2950
Provider Business Practice Location Address Fax Number:
816-960-2951
Provider Enumeration Date:
04/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
FINUF
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
D
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
816-559-9370

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  2011010462 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X , with the licence number: 22-02925 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 606546901 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200741050A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2130079 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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