| Capital Region Medical Center | |
|
180 Northstar St Holts Summit MO 65043-1123 | |
| (573) 896-5115 | |
| (573) 896-4272 |
| Full Name | Capital Region Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 180 Northstar St, Holts Summit, Missouri |
| Authorized Official Name and Position | Tom Luebbering (VP OF FINANCE) |
| Authorized Official Contact | 5736325100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Region Medical Center 180 Northstar St Holts Summit MO 65043-1123 Ph: (573) 896-5115 | Capital Region Medical Center 180 Northstar St Holts Summit MO 65043-1123 Ph: (573) 896-5115 |
| NPI Number | 1710959598 |
|---|---|
| Provider Enumeration Date | 02/06/2006 |
| Last Update Date | 08/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710959598 | NPI | - | NPPES |
| 501607808 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Ssm Regional Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 140 Northstar Dr, Holts Summit, MO 65043 Phone: 573-896-8301 Fax: 573-896-8589 |