MEDICARE: LANDMARK 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	261QP2300X	Primary Care Clinic/Center		MO

General Provider Information

NPI Number	:	1396833067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANDMARK MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	8800 NW 112TH ST
Second Line	:	SECOND FLOOR
City	:	KANSAS CITY
State	:	MO
Zip	:	64153-1104
Country	:	US
Telephone Number	:	816-464-2333
Fax Number	:	816-464-2015

Provider Business Practice Location Address
First Line	:	8800 NW 112TH ST
Second Line	:	SECOND FLOOR
City	:	KANSAS CITY
State	:	MO
Zip	:	64153-1104
Country	:	US
Telephone Number	:	816-464-2333
Fax Number	:	816-464-2015

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. SHARON ELDER
Credential	:
Telephone Number	:	816-464-2333

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/21/2022

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