1629295456 NPI number — CITY OF BELTON

Table of content: (NPI 1629295456)

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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