Organization
PRIME HEALTHCARE SERVICES BLUE SPRINGS, LLC
Active
Parent organization
PRIME HEALTHCARE SERVICES BLUE SPRINGS, LLC
Other names
St. Mary's Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME HEALTHCARE SERVICES BLUE SPRINGS, LLC
Authorized official
PREM REDDY M.D. (CHAIRMAN/PRESIDENT)
(909) 235-4400
Entity
Organization
Contact information
Practice address
201 NW R D MIZE RD, BLUE SPRINGS, MO 64014-2513
(816) 228-5900
Mailing address
201 NW R D MIZE RD, BLUE SPRINGS, MO 64014-2513
(816) 228-5900
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
403-20
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11444403
—
MO
01
—
431284526
TRICARE
—
Enumeration date
11/19/2014
Last updated
11/19/2014
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