Healthcare Provider Details

I. General information

NPI: 1982931820
Provider Name (Legal Business Name): CAMERON REGIONAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E EVERGREEN ST MP III STE A
CAMERON MO
64429-2400
US

IV. Provider business mailing address

1600 E EVERGREEN ST MP III STE A
CAMERON MO
64429-2400
US

V. Phone/Fax

Practice location:
  • Phone: 816-649-3398
  • Fax: 816-649-3379
Mailing address:
  • Phone: 816-632-2101
  • Fax: 816-649-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2472R0900X
TaxonomyRenal Dialysis Technician
License Number4737
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH F ABRUTZ JR.
Title or Position: ADMINISTRATOR
Credential:
Phone: 816-632-2101