Healthcare Provider Details
I. General information
NPI: 1437259694
Provider Name (Legal Business Name): HEARTLAND REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2006
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5325 FARAON ST
SAINT JOSEPH MO
64506-3488
US
IV. Provider business mailing address
5325 FARAON ST
SAINT JOSEPH MO
64506-3488
US
V. Phone/Fax
- Phone: 816-271-6000
- Fax:
- Phone: 816-271-6000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | 246-0 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 426-9 |
| License Number State | MO |
VIII. Authorized Official
Name:
CINDY
PATTERSON
Title or Position: PROVIDER ENROLLMENT SPECIALIST
Credential:
Phone: 816-271-7861