Healthcare Provider Details

I. General information

NPI: 1528196862
Provider Name (Legal Business Name): PRINCIPLE FIRST ASSIST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13402 BENNINGTON AVE
GRANDVIEW MO
64030-3254
US

IV. Provider business mailing address

13402 BENNINGTON AVE
GRANDVIEW MO
64030-3254
US

V. Phone/Fax

Practice location:
  • Phone: 816-304-6840
  • Fax:
Mailing address:
  • Phone: 816-304-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number00729888
License Number StateMO

VIII. Authorized Official

Name: MR. FRANCIS L LABEAF JR.
Title or Position: CEO
Credential: AS-C
Phone: 816-304-6840