=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407007180
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEART FIRST ASSIST LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2008
-----------------------------------------------------
Last Update Date | 10/01/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1000 CARONDELET DR
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64114-4673
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-943-2612
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4 W BRIDLESPUR TER
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64114-5066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-941-7404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | ELVIRA TABIJE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 816-941-7404
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 315D00000X
-----------------------------------------------------
Taxonomy Name | Inpatient Hospice
-----------------------------------------------------
License Number | 070795
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------