Healthcare Provider Details

I. General information

NPI: 1114291515
Provider Name (Legal Business Name): BURNS & MCDONNELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2012
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 WARD PKWY
KANSAS CITY MO
64114-3319
US

IV. Provider business mailing address

9400 WARD PKWY
KANSAS CITY MO
64114-3319
US

V. Phone/Fax

Practice location:
  • Phone: 816-333-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number2002002274
License Number StateMO

VIII. Authorized Official

Name: KEVIN JORDAN
Title or Position: CREDENTIALING
Credential:
Phone: 843-408-4170