Provider Demographics
NPI:1174821714
Name:CYNERGY HEALTH, LLC
Entity type:Organization
Organization Name:CYNERGY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-447-4400
Mailing Address - Street 1:1100 CLUB VILLAGE DR
Mailing Address - Street 2:STE 102
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4411
Mailing Address - Country:US
Mailing Address - Phone:573-447-4400
Mailing Address - Fax:573-303-0140
Practice Address - Street 1:1100 CLUB VILLAGE DR
Practice Address - Street 2:STE 102
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4411
Practice Address - Country:US
Practice Address - Phone:573-447-4400
Practice Address - Fax:573-303-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20000160625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H64514Medicare UPIN