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General NPI Number Information
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NPI Number | 1427190354
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Entity Type | Organization
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Legal Business Name | MIDWEST DIVISION-LSH.LLC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 807 W 2ND ST
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City | HOLDEN
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State | MO
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Zip | 64040-1291
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Country | US
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Telephone | 816-850-3612
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Fax | 816-850-3982
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Provider Business Mailing Address
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Address Line | 807 W 2ND ST
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City | HOLDEN
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State | MO
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Zip | 64040-1291
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Country | US
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Telephone | 816-850-3612
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Fax | 816-850-3982
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MATTHEW LEARY
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Credential |
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Telephone | 816-969-6533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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