Healthcare Provider Details

I. General information

NPI: 1699765123
Provider Name (Legal Business Name): CASS MEDICAL CENTER DBA CASS FAMILY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 ORIOLE ST
HARRISONVILLE MO
64701-2858
US

IV. Provider business mailing address

103 ORIOLE ST
HARRISONVILLE MO
64701-2858
US

V. Phone/Fax

Practice location:
  • Phone: 816-884-3244
  • Fax: 816-380-3970
Mailing address:
  • Phone: 816-884-3244
  • Fax: 816-380-3970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN CHRISTOPHER LANG
Title or Position: CHEIF EXECUTIVE OFFICER
Credential: CEO
Phone: 816-380-5888