Provider Demographics
NPI:1174597892
Name:CURATORS OF THE UNIVERSITY OF MISSOURI
Entity type:Organization
Organization Name:CURATORS OF THE UNIVERSITY OF MISSOURI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:RANSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-884-0054
Mailing Address - Street 1:ONE HOSPITAL DRIVE
Mailing Address - Street 2:DC026.00
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65212-0001
Mailing Address - Country:US
Mailing Address - Phone:573-882-8055
Mailing Address - Fax:
Practice Address - Street 1:1125 MADISON ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-5227
Practice Address - Country:US
Practice Address - Phone:573-632-5000
Practice Address - Fax:573-632-5932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207Q00000X, 207R00000X, 261Q00000X, 341600000X
MO419-10282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No341600000XTransportation ServicesAmbulanceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO540158508Medicaid
MO540564903Medicaid
MO010158509Medicaid
MO800564908Medicaid
MO540158508Medicaid
MO800564908Medicaid
MO000050027Medicare PIN