Healthcare Provider Details

I. General information

NPI: 1144178740
Provider Name (Legal Business Name): HEARTLAND REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MOSAIC COURT SUITE 101
SAINT JOSEPH MO
64506
US

IV. Provider business mailing address

101 MOSAIC COURT SUITE 101
SAINT JOSEPH MO
64506
US

V. Phone/Fax

Practice location:
  • Phone: 816-273-0473
  • Fax:
Mailing address:
  • Phone: 816-273-0473
  • Fax: 816-273-0473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DWIGHT CARVELL
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 816-273-0473