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General NPI Number Information
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NPI Number | 1134188741
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Entity Type | Organization
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Legal Business Name | CAPITAL REGION MEDICAL CENTER
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 3536 KUHNE ROAD
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City | OWENSVILLE
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State | MO
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Zip | 65066
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Country | US
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Telephone | 573-437-4168
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Fax | 573-437-4242
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Provider Business Mailing Address
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Address Line | 3536 KUHNE ROAD
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City | OWENSVILLE
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State | MO
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Zip | 65066
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Country | US
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Telephone | 573-437-4168
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Fax | 573-437-4242
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | TOM LUEBBERING
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Credential |
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Telephone | 573-632-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 4199
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License Number State | MO
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