Healthcare Provider Details

I. General information

NPI: 1477670149
Provider Name (Legal Business Name): MCFAD MANAGED CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 ROCKHILL RD STE 203
KANSAS CITY MO
64131-1117
US

IV. Provider business mailing address

6301 ROCKHILL STE 203
KANSAS CITY MO
64130
US

V. Phone/Fax

Practice location:
  • Phone: 816-333-2133
  • Fax: 816-333-0540
Mailing address:
  • Phone: 816-333-2133
  • Fax: 816-333-0540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateMO

VIII. Authorized Official

Name: MRS. KATHERINE SANDERS
Title or Position: PRESIDENT CEO
Credential:
Phone: 816-333-2133