=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356408520
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE CHILDREN'S MERCY HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2007
-----------------------------------------------------
Last Update Date | 04/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2401 GILLHAM RD
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64108-4619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-234-3055
-----------------------------------------------------
Fax | 816-855-1956
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2401 GILLHAM RD ATTN: PROVIDER ENROLLMENT
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64108-4619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-701-5200
-----------------------------------------------------
Fax | 816-302-9939
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SENIOR VICE PRESIDENT
-----------------------------------------------------
Name | ROBERT FINUF II
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 816-701-5200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 001769
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0004X
-----------------------------------------------------
Taxonomy Name | Compounding Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 22-01875
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------