Provider Demographics
NPI:1568992675
Name:ROCKHILL ORTHOPAEDIC SPECIALISTS INC
Entity Type:Organization
Organization Name:ROCKHILL ORTHOPAEDIC SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-347-4891
Mailing Address - Street 1:120 NE SAINT LUKES BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-6011
Mailing Address - Country:US
Mailing Address - Phone:816-246-4302
Mailing Address - Fax:816-246-8910
Practice Address - Street 1:600 NE ADAMS DAIRY PKWY STE 160
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-5496
Practice Address - Country:US
Practice Address - Phone:816-246-4302
Practice Address - Fax:816-246-9493
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT LUKE'S HEALTH SYSTEM INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO6684830001OtherMEDICARE NSC
MOMA3922OtherMEDICARE UPIN