1891883450 NPI number — VILMER & VILMER MDS PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891883450 NPI number — VILMER & VILMER MDS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VILMER & VILMER MDS PC
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:
1891883450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2750 CLAY EDWARDS DRIVE
Provider Second Line Business Mailing Address:
SUITE 308
Provider Business Mailing Address City Name:
NORTH KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64116-3256
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-842-8404
Provider Business Mailing Address Fax Number:
816-842-9531

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2750 CLAY EDWARDS DRIVE
Provider Second Line Business Practice Location Address:
SUITE 308
Provider Business Practice Location Address City Name:
NORTH KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64116-3256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-842-8404
Provider Business Practice Location Address Fax Number:
816-842-9531
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VILMER
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
816-842-8404

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01891011 . This is a "BCBS OF KANSAS CITY" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com