Basic Information
| Provider Information | |||||||||
| NPI: | 1295184281 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE KANSAS CITY VA MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4746 ROANOKE PKWY | ||||||||
| Address2: | APT 605 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641121897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133348905 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4801 E LINWOOD BLVD | ||||||||
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| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641282226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8168614700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2016 | ||||||||
| LastUpdateDate: | 06/09/2016 | ||||||||
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| AuthorizedOfficialLastName: | MCCRANEY | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8168614700 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | VETERANS HEALTH ADMINISTRATION | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 286500000X | 2014010561 | MO | Y | Hospitals | Military Hospital |
No ID Information.