Healthcare Provider Details

I. General information

NPI: 1902975238
Provider Name (Legal Business Name): HEARTLAND REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 FARAON
SAINT JOSEPH MO
64506-3398
US

IV. Provider business mailing address

5325 FARAON ST
SAINT JOSEPH MO
64506-3488
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-6000
  • Fax:
Mailing address:
  • Phone: 816-271-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CINDY G PATTERSON
Title or Position: PROVIDER ENROLLMENT SPECIALIST
Credential:
Phone: 816-271-7861