1588728018 NPI number — HARRY S. TRUMAN CHILDRENS NEUROLOGICAL CENTER

Table of content: MR. JOSEPH ANTHONY SALGADO SR. (NPI 1649914359)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588728018 NPI number — HARRY S. TRUMAN CHILDRENS NEUROLOGICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRY S. TRUMAN CHILDRENS NEUROLOGICAL CENTER
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:
1588728018
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12404 E US HIGHWAY 40
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDEPENDENCE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64055-5954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-373-5060
Provider Business Mailing Address Fax Number:
816-373-5787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8316 PERSHING RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAYTOWN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64138-3633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-737-8178
Provider Business Practice Location Address Fax Number:
816-353-3607
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LANDRUM
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
816-373-5060

Provider Taxonomy Codes

  • Taxonomy code: 320900000X , with the licence number:  12606545 , 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: 852522838 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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