Central Care PA
Organization Active NPI Non-Pharmacy Dispensing Site · Bolivar, MO
NPI 1316372154 · NPPES record last updated Apr 2, 2024
Key facts
- NPI
- 1316372154
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Non-Pharmacy Dispensing Site 332900000X
- License
- 002905 (MO)
- Legal business name
- CENTRAL CARE PA
- Practice address
- 1501 N Oakland Ave
Bolivar, MO 65613-3020 - Phone
- (417) 326-7200
- Fax
- (417) 326-7201
- NPI assigned
- Sep 12, 2013
- Organization subpart
- No
Authorized official
- Name
- Candice Evans
- Title
- Credentialing
- Phone
- (620) 603-8846
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 19
Practitioners 15
-
Jennifer A Bushre, APRN, NP
-
Bethany M Martin, FNP-C
-
Bailey D Shunyakov, APRN, NP-C
-
Leonid Shunyakov, MD
-
Gina Nicole Viser, FNP-C
-
Kandi L Arwine, FNP-C
-
Elizabeth A Berger, PA-C
-
Elshami M Elamin, MD
-
Mark Fesen, MD
-
Omoruyi C Irabor, MD, MPH
-
Hannah R Schmidt, DNP-C
-
Ali Wazir, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140324001978 | MO | DME Supplier - Physician - General Surgery | 7911801014 | Practice locations: Bolivar, MO |
National Provider Directory
- Tax ID family
- Invalid Entry
Locations
1501 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-7200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Oncology Physician |
207RX0202X | |||
| Radiation Oncology Physician |
2085R0001X | |||
| Non-Pharmacy Dispensing Site | 332900000X | 002905 | MO | Yes |
Addresses
Primary practice location
1501 N Oakland Ave
Bolivar, MO 65613-3020
Mailing address
PO Box 256
Salina, KS 67402-0256
Phone (785) 823-0633
Other names
- CENTRAL CARE CANCER CENTER
Other providers in Bolivar, MO
- Zachary Carel
- Carl L. Blomenkamp,D.C.,P.C.
- Chad Lee Carrel
- Cara Lea Carrington
- Casablanca Care Center, LLC
- Central Care, PA
- Chiropractic Health and Wellness Center LLC
- Grace Cidlik
- Citizens Memorial Health Care Foundation
- Citizens Memorial Health Care Foundation
All providers in Bolivar, MO · Non-Pharmacy Dispensing Site in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.