Healthcare Provider Details

I. General information

NPI: 1902197270
Provider Name (Legal Business Name): THE CHILDREN'S MERCY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2011
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 BROADWAY BLVD
KANSAS CITY MO
64111-2659
US

IV. Provider business mailing address

2401 GILLHAM RD ATTN: PROVIDER ENROLLMENT
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 816-960-2950
  • Fax:
Mailing address:
  • Phone: 816-701-5200
  • Fax: 816-302-9939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2011010462
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number22-02925
License Number StateKS

VIII. Authorized Official

Name: ROBERT D FINUF II
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 816-701-5200