Healthcare Provider Details

I. General information

NPI: 1447550983
Provider Name (Legal Business Name): CAH ACQUISITION COMPANY 6 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E HOSPITAL DR
SWEET SPRINGS MO
65351-2229
US

IV. Provider business mailing address

105 E HOSPITAL DR
SWEET SPRINGS MO
65351-2229
US

V. Phone/Fax

Practice location:
  • Phone: 660-335-7400
  • Fax: 660-335-7487
Mailing address:
  • Phone: 660-335-7400
  • Fax: 660-335-7487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number516-1
License Number StateMO

VIII. Authorized Official

Name: JEFFREY W GANNON
Title or Position: BUSSINESS OFFICE DIRECTOR
Credential:
Phone: 660-335-7407