Provider Demographics
NPI:1265862049
Name:MIDWEST DIVISION - RMC, LLC
Entity type:Organization
Organization Name:MIDWEST DIVISION - RMC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KRAJICEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-276-4101
Mailing Address - Street 1:2323 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-3462
Mailing Address - Country:US
Mailing Address - Phone:816-444-8161
Mailing Address - Fax:816-333-4495
Practice Address - Street 1:2323 E 63RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64130-3462
Practice Address - Country:US
Practice Address - Phone:816-444-8161
Practice Address - Fax:816-333-4495
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWEST DIVISION - RMC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-15
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
26S027Medicare Oscar/Certification