1174960769 NPI number — HCC NETWORK

Table of content: BRANDI LYNNE MARIE ANDREOLA (NPI 1154814275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174960769 NPI number — HCC NETWORK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HCC NETWORK
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:
6
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:
1174960769
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
825 S BUSINESS HIGHWAY 13
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64067-1515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-259-2440
Provider Business Mailing Address Fax Number:
660-259-2440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
608 MISSOURI STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAVERLY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64096-8421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-344-3572
Provider Business Practice Location Address Fax Number:
866-228-4492
Provider Enumeration Date:
05/23/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RICHARD
Authorized Official First Name:
TONIANN
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
660-259-2440

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , 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)