1265090393 NPI number — CHILDREN'S MERCY-HEALTH CARE FOR CHILDREN, INC

Table of content: (NPI 1265090393)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265090393 NPI number — CHILDREN'S MERCY-HEALTH CARE FOR CHILDREN, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDREN'S MERCY-HEALTH CARE FOR CHILDREN, INC
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:
1265090393
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 ENROLLMENT DEPT
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:
816-701-5201
Provider Business Mailing Address Fax Number:
816-302-9939

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9051 NE 81ST TER STE 100
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:
64158-1168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-792-1170
Provider Business Practice Location Address Fax Number:
816-792-3877
Provider Enumeration Date:
06/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
FINUF
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
D
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
816-701-5200

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com