Provider Demographics
NPI:1356323794
Name:CASS REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:CASS REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:J
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-380-5888
Mailing Address - Street 1:2800 E ROCK HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-4411
Mailing Address - Country:US
Mailing Address - Phone:816-380-3474
Mailing Address - Fax:816-380-4639
Practice Address - Street 1:2800 E ROCK HAVEN RD
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-4411
Practice Address - Country:US
Practice Address - Phone:816-380-3474
Practice Address - Fax:816-380-4639
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASS REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-18
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO219-42275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26Z324Medicare Oscar/Certification