1396731626 NPI number — STATE OF KANSAS - ACCOUNTING SERVICES

Table of content: (NPI 1396731626)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396731626 NPI number — STATE OF KANSAS - ACCOUNTING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STATE OF KANSAS - ACCOUNTING SERVICES
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:
SCHIEFELBUSCH SPEECH-LANGUAGE-HEARING CLINIC
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:
1396731626
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 SUNNYSIDE AVE
Provider Second Line Business Mailing Address:
2101 HAWORTH HALL
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66045-7534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-864-4690
Provider Business Mailing Address Fax Number:
785-864-5094

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 SUNNYSIDE AVENUE
Provider Second Line Business Practice Location Address:
2101 HAWORTH HALL
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66045-7534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-864-4690
Provider Business Practice Location Address Fax Number:
785-864-5094
Provider Enumeration Date:
09/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WEGNER
Authorized Official First Name:
JANE
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINIC DIRECTOR
Authorized Official Telephone Number:
785-864-4690

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  1158 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 00123 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 235Z00000X , with the licence number: 00233 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 02138 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 02157 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 01870 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 00953 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: 02297 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 100215990A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 011803 . This is a "BCBS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100008080D , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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