MEDICARE: CAMERON REGIONAL MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	473-11	MO

General Provider Information

NPI Number	:	1174955033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMERON REGIONAL MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	1600 E EVERGREEN ST
Second Line	:
City	:	CAMERON
State	:	MO
Zip	:	64429-2400
Country	:	US
Telephone Number	:	816-632-2101
Fax Number	:	816-649-3383

Provider Business Practice Location Address
First Line	:	411 N PENNSYLVANIA AVE
Second Line	:
City	:	LAWSON
State	:	MO
Zip	:	64062-9402
Country	:	US
Telephone Number	:	816-632-2101
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JOSEPH F ABRUTZ JR.
Credential	:
Telephone Number	:	816-649-3203

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	08/02/2013

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