Provider Demographics
NPI:1417971565
Name:CAMERON REGIONAL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:CAMERON REGIONAL MEDICAL CENTER INC
Other - Org Name:CAMERON REGIONAL MEDICAL CENTER HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:ABRUTZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:816-632-2101
Mailing Address - Street 1:1005 W 3RD ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-1415
Mailing Address - Country:US
Mailing Address - Phone:816-632-5124
Mailing Address - Fax:816-632-6121
Practice Address - Street 1:214 MCELWAIN DR STE B
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-1350
Practice Address - Country:US
Practice Address - Phone:816-632-5124
Practice Address - Fax:816-632-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1321251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO223476OtherHOMELINK
MO30440019OtherBC/BS FEDERAL
MO580636108Medicaid
MS033335OtherFAMILY HEALTH PARTNERS
MO614216OtherFIRST HEALTH
MO492466602OtherTRICARE
MO90248019OtherBLUECROSS BLUESHIELD
MO492466602OtherTRICARE
MO=========01OtherCOMMUNITY HEALTH