Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Capital Region Medical Center-HME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM LUEBBERING (VICE PRESIDENT-FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5750
(573) 632-5868
Mailing address
7748 WATSON ROAD, SAINT LOUIS, MO 63119-5407
(573) 632-5750
(573) 632-5868
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
412 12
MO
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
41212
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620158501
—
MO
Enumeration date
11/08/2006
Last updated
10/05/2016
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