Provider Demographics
NPI:1033499256
Name:UNIVERSITY OF MISSORI HEALTH SYSTEM
Entity Type:Organization
Organization Name:UNIVERSITY OF MISSORI HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:WINNIFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRNSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-814-6631
Mailing Address - Street 1:1956 W OLD PLANK VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-9376
Mailing Address - Country:US
Mailing Address - Phone:573-228-9137
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF MEDICINE UNIV OF MISSOURI
Practice Address - Street 2:ONE HOSPITAL DRIVE NE402
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-8857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
No273R00000XHospital UnitsPsychiatric Unit
No273Y00000XHospital UnitsRehabilitation Unit
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No291U00000XLaboratoriesClinical Medical Laboratory
No293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
0-652-088-6OtherEDUCATIONAL COMMISSION FOR FOREIGN MEDICAL GRADUATES
12164229OtherAMERICAN ASSOCIATION OF MEDICAL COLLEGES