Provider Demographics
NPI:1639355043
Name:THE GIFT CENTER
Entity Type:Organization
Organization Name:THE GIFT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNYE
Authorized Official - Middle Name:CARROLLE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-309-0715
Mailing Address - Street 1:9812 E 87TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-4773
Mailing Address - Country:US
Mailing Address - Phone:816-309-0715
Mailing Address - Fax:
Practice Address - Street 1:9812 E 87TH ST STE D
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-4773
Practice Address - Country:US
Practice Address - Phone:816-309-0715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization