Provider Demographics
NPI:1447550983
Name:CAH ACQUISITION COMPANY 6 LLC
Entity type:Organization
Organization Name:CAH ACQUISITION COMPANY 6 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSSINESS OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:GANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-335-7407
Mailing Address - Street 1:105 E HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SWEET SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65351-2229
Mailing Address - Country:US
Mailing Address - Phone:660-335-7400
Mailing Address - Fax:660-335-7487
Practice Address - Street 1:105 E HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SWEET SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65351-2229
Practice Address - Country:US
Practice Address - Phone:660-335-7400
Practice Address - Fax:660-335-7487
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAH ACQUISITION COMPANY 6 LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO516-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1184864779Medicaid
MO1184864779Medicaid