Provider Demographics
NPI:1598710097
Name:CAH ACQUISITION COMPANY 6 LLC
Entity Type:Organization
Organization Name:CAH ACQUISITION COMPANY 6 LLC
Other - Org Name:I 70 COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-335-7408
Mailing Address - Street 1:105 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:SWEET SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65351-2229
Mailing Address - Country:US
Mailing Address - Phone:660-335-4700
Mailing Address - Fax:660-335-7478
Practice Address - Street 1:105 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:SWEET SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65351-2229
Practice Address - Country:US
Practice Address - Phone:660-335-4700
Practice Address - Fax:660-335-7478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO493-0282NC0060X, 282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO540956901Medicaid
MO91264016OtherBC PROVIDER NUMBER
MO016238107Medicaid
MO016238107Medicaid
MO540956901Medicaid
MOW050000Medicare ID - Type UnspecifiedPROFEE BILLING