# FULTON MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fulton Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841600095
- **Authorized official:** MR. DANIEL R TASSET (VICE CHAIR, NUEHEALTH)
- **Authorized official phone:** (913) 387-0510

## Contact information

- **Practice address:** 850 N HOSPITAL DR, SUITE F, FULTON, MO 65251-2535
- **Practice address phone:** (573) 642-5338
- **Mailing address:** 11221 ROE AVE, SUITE 320, LEAWOOD, KS 66211-1922
- **Mailing address phone:** (913) 387-0510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/28/2014
- **Last updated:** 05/20/2020