Organization
SAMUEL U. RODGERS HEALTH CENTER, INC.
Active
Other names
Samuel U. Rodgers Health Center Clay County Family Medicine & Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT THEIS (ACTING CEO)
(816) 474-4920
Entity
Organization
Contact information
Practice address
800 HAINES DRIVE, LIBERTY, MO 64068
(816) 792-1575
(816) 889-1803
Mailing address
825 EUCLID AVE, KANSAS CITY, MO 64124-2323
(816) 474-4920
(816) 889-1845
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504119702
—
MO
Enumeration date
11/17/2009
Last updated
06/11/2019
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