Provider Demographics
NPI:1093826935
Name:NORTHLAND HOSPITALSTS LLC
Entity Type:Organization
Organization Name:NORTHLAND HOSPITALSTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-455-0681
Mailing Address - Street 1:2800 CLAY EDWARDS DR
Mailing Address - Street 2:
Mailing Address - City:N KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3220
Mailing Address - Country:US
Mailing Address - Phone:816-455-0681
Mailing Address - Fax:816-455-5294
Practice Address - Street 1:3724 N QUINCY CIRCLE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-0278
Practice Address - Country:US
Practice Address - Phone:816-455-0681
Practice Address - Fax:816-455-5294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOS710000Medicare ID - Type UnspecifiedGROUP NUMBER