NPI 1316344658

Icare Primary Care

Organisation Exclusive Provider Organization Liberty, MO

Practice location

Address: 550 Rush Creek Pkwy Suite B, Liberty, MO 64068-9608
Phone: (816) 875-4325
Fax: (816) 407-9809

Authorised official

Name: Jennifer Petersen
Title: Office Manager
Phone: (816) 875-4325

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 20110330076 (MO)

Other Exclusive Provider Organization providers in Missouri →

Registry record

NPI: 1316344658
Entity type: Organization
NPI issued: 2 Dec 2014
Record last updated: 2 Dec 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.