Organization
COMMUNITY HOSPITAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON P DAVIS (CFO)
(660) 686-2320
Entity
Organization
Contact information
Practice address
26136 US HIGHWAY 59, FAIRFAX, MO 64446-8155
(660) 686-2211
(660) 686-2618
Mailing address
26136 US HWY 59, FAIRFAX, MO 64446-9105
(660) 686-2211
(660) 686-2618
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
102-48
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010492502
—
MO
05
—
540492501
—
MO
01
—
90060015
BCBS OF KANSAS CITY
MO
Enumeration date
03/16/2006
Last updated
03/30/2017
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