Provider Demographics
NPI:1508002635
Name:CASS REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:CASS REGIONAL MEDICAL CENTER
Other - Org Name:PLEASANT HILL MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-380-5888
Mailing Address - Street 1:1601 N HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:MO
Mailing Address - Zip Code:64080-1945
Mailing Address - Country:US
Mailing Address - Phone:816-540-2111
Mailing Address - Fax:816-540-6065
Practice Address - Street 1:1601 N HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:MO
Practice Address - Zip Code:64080-1945
Practice Address - Country:US
Practice Address - Phone:816-540-2111
Practice Address - Fax:816-540-6065
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASS REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
7060000Medicare PIN