Provider Demographics
NPI:1811905375
Name:CAMERON REGIONAL MEDICAL CENTER INC
Entity type:Organization
Organization Name:CAMERON REGIONAL MEDICAL CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-632-2101
Mailing Address - Street 1:1600 E EVERGREEN ST
Mailing Address - Street 2:PO BOX 557
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-2400
Mailing Address - Country:US
Mailing Address - Phone:816-632-2101
Mailing Address - Fax:816-649-3383
Practice Address - Street 1:1600 E EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-2400
Practice Address - Country:US
Practice Address - Phone:816-632-2101
Practice Address - Fax:816-649-3383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO4733282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO540636107Medicaid
MO010636108Medicaid
MO7850000Medicare ID - Type UnspecifiedUSED ON 1500
MO260057Medicare ID - Type UnspecifiedUSED ON UB