Healthcare Provider Details

I. General information

NPI: 1740775212
Provider Name (Legal Business Name): SOCIAL WELFARE BOARD OF THE COUNTY OF BUCHANAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 S 10TH ST STE A
SAINT JOSEPH MO
64503-2400
US

IV. Provider business mailing address

904 S 10TH ST STE A
SAINT JOSEPH MO
64503-2400
US

V. Phone/Fax

Practice location:
  • Phone: 816-344-5201
  • Fax: 816-355-5247
Mailing address:
  • Phone: 816-233-5188
  • Fax: 816-344-5247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LINDA CARMEL JUDAH
Title or Position: EXECUTIVE DIRECTOR
Credential: MSN RN
Phone: 816-344-5201