Healthcare Provider Details

I. General information

NPI: 1518152966
Provider Name (Legal Business Name): RAMIC INDEPENDENCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3431 S HWY 291
INDEPENDENCE MO
64057-2341
US

IV. Provider business mailing address

100 PARAGON DR
MONTVALE NJ
07645-1779
US

V. Phone/Fax

Practice location:
  • Phone: 816-795-6266
  • Fax: 816-795-6966
Mailing address:
  • Phone: 201-573-8080
  • Fax: 201-573-4629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW SHIPPAM
Title or Position: PRESIDENT
Credential:
Phone: 302-472-9101