1417971953 NPI number — BOONE HOSPITAL CENTER'S VISITING NURSES, INC.

Table of content: (NPI 1417971953)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417971953 NPI number — BOONE HOSPITAL CENTER'S VISITING NURSES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOONE HOSPITAL CENTER'S VISITING NURSES, 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:
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:
1417971953
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1605 E. BROADWAY
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-875-0555
Provider Business Mailing Address Fax Number:
573-875-0606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1605 E. BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-875-0555
Provider Business Practice Location Address Fax Number:
573-875-0606
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHAMBERS
Authorized Official First Name:
BARRY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
573-815-3072

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  088-8HO , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X , with the licence number: 088-16HO , 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: 149839 . This is a "BC/BS OF MO - HOSPICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 940562804 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 60-00027 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110232 . This is a "HEALTHLINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 18735 . This is a "HEALTHCARE USA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 580562809 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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