1467494815 NPI number — CITY OF CHILLICOTHE

Table of content: (NPI 1467494815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467494815 NPI number — CITY OF CHILLICOTHE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF CHILLICOTHE
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:
1467494815
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 410204
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:
64141-0204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-646-2139
Provider Business Mailing Address Fax Number:
660-707-0434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHILLICOTHEE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64601-2555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-646-2139
Provider Business Practice Location Address Fax Number:
660-707-0434
Provider Enumeration Date:
06/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
REETER
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
S
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
660-646-2139

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , with the licence number: 117005 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 11263011 . This is a "BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 800546608 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9004054 . This is a "MEDICARE B" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 590077720 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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