1023345006 NPI number — ASSOCIATES IN FAMILY HEALTH CARE

Table of content: (NPI 1023345006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023345006 NPI number — ASSOCIATES IN FAMILY HEALTH CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATES IN FAMILY HEALTH CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KANSAS CITY SPORTS MEDICINE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023345006
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
712 1ST TERRACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-727-6000
Provider Business Mailing Address Fax Number:
913-341-1346

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
712 1ST TER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANSING
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66043-1735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-727-6000
Provider Business Practice Location Address Fax Number:
913-341-1346
Provider Enumeration Date:
11/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BURCH
Authorized Official First Name:
JAIME
Authorized Official Middle Name:
SUE
Authorized Official Title or Position:
CLINIC DIRECTOR
Authorized Official Telephone Number:
913-727-6000

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  04-28802 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100358700A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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