1942346804 NPI number — THE CHILDREN'S MERCY HOSPITAL

Table of content: (NPI 1942346804)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942346804 NPI number — THE CHILDREN'S MERCY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CHILDREN'S 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 CRITICAL CARE TRANSPORT
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:
1942346804
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:
816-234-3000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2401 GILLHAM RD
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:
64108-4619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-234-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RALSTON
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
PROVIDER ENROLLMENT MANAGER
Authorized Official Telephone Number:
816-701-5201

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  095231 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416A0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 010931608 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100080290A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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