1063470763 NPI number — MIDWEST DIVISION - RBH, LLC

Table of content: (NPI 1063470763)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063470763 NPI number — MIDWEST DIVISION - RBH, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDWEST DIVISION - RBH, LLC
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:
BELTON REGIONAL MEDICAL CENTER
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:
1063470763
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17065 S 71 HWY
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:
64012-2165
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-348-1200
Provider Business Mailing Address Fax Number:
816-348-1271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17065 S 71 HWY
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:
64012-2165
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-348-1200
Provider Business Practice Location Address Fax Number:
816-348-1271
Provider Enumeration Date:
05/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
RONNIE
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
816-348-1810

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8659 . This is a "HEALTHCARE USA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1704113 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 604109600 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 757900 . This is a "FAMILY HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 90211030 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 16185803 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200365240A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 516430 . This is a "FIRST GUARD" identifier . This identifiers is of the category "OTHER".




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