| Samuel U. Rodgers Health Center Northland Family Medicine | |
|
5330 N Oak Trfy Ste 104 Kansas City MO 64118-4600 | |
| (816) 889-1950 | |
| (816) 499-8101 |
| Full Name | Samuel U. Rodgers Health Center Northland Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 5330 N Oak Trfy Ste 104, Kansas City, Missouri |
| Authorized Official Name and Position | Hilda Fuentes (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8168894600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel U. Rodgers Health Center Northland Family Medicine 825 Euclid Ave Kansas City MO 64124-2323 Ph: (816) 474-4920 | Samuel U. Rodgers Health Center Northland Family Medicine 5330 N Oak Trfy Ste 104 Kansas City MO 64118-4600 Ph: (816) 889-1950 |
| NPI Number | 1386195113 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9739092826 |
|---|---|
| Medicare Enrollment ID | O20170905002968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386195113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Missouri) | Primary |
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