=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417971565
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAMERON REGIONAL MEDICAL CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2006
-----------------------------------------------------
Last Update Date | 11/30/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 214 MCELWAIN DR STE B
-----------------------------------------------------
City | CAMERON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64429-1350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-632-5124
-----------------------------------------------------
Fax | 816-632-6121
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1005 W 3RD ST SUITE 3
-----------------------------------------------------
City | CAMERON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64429-1415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-632-5124
-----------------------------------------------------
Fax | 816-632-6121
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. JOSEPH F ABRUTZ JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 816-632-2101
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1321
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------