Basic Information
| Provider Information | |||||||||
| NPI: | 1285920504 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY OF MISSOURI - COLUMBIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE HOSPITAL DRIVE, DC018.00 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738828885 | ||||||||
| FaxNumber: | 5738844249 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE HOSPITAL DRIVE, DC018.00 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738828885 | ||||||||
| FaxNumber: | 5738844249 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2011 | ||||||||
| LastUpdateDate: | 06/24/2011 | ||||||||
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| AuthorizedOfficialLastName: | ERICKSON | ||||||||
| AuthorizedOfficialFirstName: | DEE ANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | GME ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5738828885 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UNIVERSITY HOSPITAL & CLINICS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2011013993 | MO | Y | Hospitals | General Acute Care Hospital |
No ID Information.