Provider Demographics
NPI:1841276672
Name:CITY OF KANSAS CITY MISSOURI
Entity type:Organization
Organization Name:CITY OF KANSAS CITY MISSOURI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REX
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:816-513-6252
Mailing Address - Street 1:2400 TROOST AVE
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2666
Mailing Address - Country:US
Mailing Address - Phone:816-513-6008
Mailing Address - Fax:816-513-6285
Practice Address - Street 1:2400 TROOST AVE
Practice Address - Street 2:SUITE 4000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2666
Practice Address - Country:US
Practice Address - Phone:816-513-6008
Practice Address - Fax:816-513-6285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO511130817Medicaid
9004239Medicare ID - Type Unspecified