Healthcare Provider Details

I. General information

NPI: 1235381120
Provider Name (Legal Business Name): CAH ACQUISITION COMPANY #6 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 S MAIN SUITE B
CONCORDIA MO
64020-0000
US

IV. Provider business mailing address

1100 MAIN ST SUITE 2350
KANSAS CITY MO
64105-2120
US

V. Phone/Fax

Practice location:
  • Phone: 660-463-1010
  • Fax: 660-463-1070
Mailing address:
  • Phone: 660-463-1010
  • Fax: 660-463-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE A DAVENPORT
Title or Position: CEO
Credential: RN
Phone: 660-335-7408