Healthcare Provider Details

I. General information

NPI: 1851391767
Provider Name (Legal Business Name): TUTERA ACQUIRERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 04/23/2021
Certification Date: 04/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 MUNGER LN
HANNIBAL MO
63401-2361
US

IV. Provider business mailing address

328 MUNGER LN
HANNIBAL MO
63401-2361
US

V. Phone/Fax

Practice location:
  • Phone: 573-221-9122
  • Fax: 573-221-9166
Mailing address:
  • Phone: 573-221-9122
  • Fax: 573-221-9166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number026664
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number026664
License Number StateMO

VIII. Authorized Official

Name: JOSEPH C TUTERA
Title or Position: CEO
Credential:
Phone: 816-444-0900