1174502272 NPI number — ENDOSCOPY CENTER OF TOPEKA LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174502272 NPI number — ENDOSCOPY CENTER OF TOPEKA LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENDOSCOPY CENTER OF TOPEKA LP
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:
THE ENDOSCOPY AND SURGERY CENTER OF TOPEKA
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:
1174502272
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 SW 6TH AVE
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
TOPEKA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66606-1707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-354-1254
Provider Business Mailing Address Fax Number:
785-354-1598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 SW 6TH AVE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66606-1707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-354-1254
Provider Business Practice Location Address Fax Number:
785-354-1598
Provider Enumeration Date:
01/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CLENDENIN
Authorized Official First Name:
PHILLIP
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
615-665-1283

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  S-089-004 , 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: 100215630-A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com