Healthcare Provider Details

I. General information

NPI: 1558394064
Provider Name (Legal Business Name): CAH ACQUISITION COMPANY 6 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 HOSPITAL DRIVE BLDG B
SWEET SPRINGS MO
65351-2229
US

IV. Provider business mailing address

105 HOSPITAL DRIVE
SWEET SPRINGS MO
65351-2229
US

V. Phone/Fax

Practice location:
  • Phone: 660-335-7074
  • Fax: 660-335-9955
Mailing address:
  • Phone: 660-335-4700
  • Fax: 660-335-7487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateMO

VIII. Authorized Official

Name: JEFFREY W BLOEMKER
Title or Position: CEO
Credential:
Phone: 660-335-4700