Provider Demographics
NPI: | 1992692149 |
---|---|
Name: | THE CHILDREN'S MERCY HOSPITAL |
Entity type: | Organization |
Organization Name: | THE CHILDREN'S MERCY HOSPITAL |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SENIOR VICE PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | D |
Authorized Official - Last Name: | FINUF |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 816-701-5200 |
Mailing Address - Street 1: | 2401 GILLHAM ROAD |
Mailing Address - Street 2: | PROVIDER ENROLLMENT DEPARTMENT |
Mailing Address - City: | KANSAS CITY |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 64108-4619 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 816-379-3272 |
Mailing Address - Fax: | 816-302-9939 |
Practice Address - Street 1: | 700 NW ARGOSY PKWY |
Practice Address - Street 2: | |
Practice Address - City: | RIVERSIDE |
Practice Address - State: | MO |
Practice Address - Zip Code: | 64150-1512 |
Practice Address - Country: | US |
Practice Address - Phone: | 816-895-5100 |
Practice Address - Fax: | 816-302-9939 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | THE CHILDREN'S MERCY HOSPITAL |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2025-06-20 |
Last Update Date: | 2025-06-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3336C0003X | Suppliers | Pharmacy | Community/Retail Pharmacy |