Provider Demographics
NPI:1710506845
Name:CORE MEDICAL HH LLC
Entity Type:Organization
Organization Name:CORE MEDICAL HH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASTON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:816-674-2693
Mailing Address - Street 1:1131 W MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-3611
Mailing Address - Country:US
Mailing Address - Phone:816-229-1941
Mailing Address - Fax:816-229-7085
Practice Address - Street 1:1131 W MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-3611
Practice Address - Country:US
Practice Address - Phone:816-229-1941
Practice Address - Fax:816-229-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health