Organization
SAMUEL U. RODGERS HEALTH CENTER, INC.
Active
Parent organization
SAMUEL U. RODGERS HEALTH CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAMUEL U. RODGERS HEALTH CENTER, INC.
Authorized official
ROBERT THEIS (ACTING CEO)
(816) 889-4802
Entity
Organization
Contact information
Practice address
2100 E 9TH ST, KANSAS CITY, MO 64124
(816) 474-4920
(816) 474-4914
Mailing address
2100 E 9TH ST, KANSAS CITY, MO 64124-2364
(816) 474-4920
(816) 474-4914
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170859102
—
MO
01
—
26-1832
MEDICARE A
MO
Enumeration date
02/01/2008
Last updated
06/07/2018
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