Healthcare Provider Details

I. General information

NPI: 1760884894
Provider Name (Legal Business Name): CAMERON REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

1600 E EVERGREEN ST
CAMERON MO
64429-2400
US

V. Phone/Fax

Practice location:
  • Phone: 816-649-0500
  • Fax: 816-649-0049
Mailing address:
  • Phone: 816-632-2101
  • Fax: 816-649-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number473-12
License Number StateMO

VIII. Authorized Official

Name: MR. JOSEPH F ABRUTZ JR.
Title or Position: ADMINISTRATOR
Credential:
Phone: 816-649-3203