Healthcare Provider Details

I. General information

NPI: 1790733608
Provider Name (Legal Business Name): HEARTLAND REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 HEARTLAND RD PLAZA II SUITE 1810
SAINT JOSEPH MO
64506-6200
US

IV. Provider business mailing address

901 HEARTLAND RD PLAZA II SUITE 1810
SAINT JOSEPH MO
64506-6200
US

V. Phone/Fax

Practice location:
  • Phone: 816-671-4888
  • Fax: 816-671-4890
Mailing address:
  • Phone: 816-671-4888
  • Fax: 816-671-4890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberMOMDR7297
License Number StateMO

VIII. Authorized Official

Name: GEORGE D MULDER
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 816-671-4888