Provider Demographics
NPI:1821035882
Name:CENTERPOINT MEDICAL CENTER OF INDEPENDENCE, LLC
Entity Type:Organization
Organization Name:CENTERPOINT MEDICAL CENTER OF INDEPENDENCE, LLC
Other - Org Name:CENTERPOINT MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-698-7001
Mailing Address - Street 1:19600 E 39TH ST S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2301
Mailing Address - Country:US
Mailing Address - Phone:816-836-8100
Mailing Address - Fax:816-836-6603
Practice Address - Street 1:19600 E 39TH ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2301
Practice Address - Country:US
Practice Address - Phone:816-836-8100
Practice Address - Fax:816-836-6603
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTERPOINT MEDICAL CENTER OF INDEPENDENCE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-31
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
26T095Medicare Oscar/Certification