Healthcare Provider Details

I. General information

NPI: 1477535326
Provider Name (Legal Business Name): CASS REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E ROCK HAVEN RD
HARRISONVILLE MO
64701-4411
US

IV. Provider business mailing address

2800 E ROCK HAVEN RD
HARRISONVILLE MO
64701-4411
US

V. Phone/Fax

Practice location:
  • Phone: 816-380-3474
  • Fax: 816-887-0315
Mailing address:
  • Phone: 816-380-3474
  • Fax: 816-887-0315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number219-42
License Number StateMO

VIII. Authorized Official

Name: MR. J. CHRISTOPHER LANG
Title or Position: CEO
Credential:
Phone: 816-380-5888