1467593095 NPI number — SHAWNEE MISSION HEMATOLOGY AND ONCOLOGY

Table of content: (NPI 1467593095)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467593095 NPI number — SHAWNEE MISSION HEMATOLOGY AND ONCOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHAWNEE MISSION HEMATOLOGY AND ONCOLOGY
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:
Provider Other Organization Name Type Code:
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:
1467593095
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 413081
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64141-3081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-248-9693
Provider Business Mailing Address Fax Number:
913-248-9383

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8901 W 74TH ST
Provider Second Line Business Practice Location Address:
SUITE 312
Provider Business Practice Location Address City Name:
SHAWNEE MISSION
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66204-2204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-236-4500
Provider Business Practice Location Address Fax Number:
913-236-4549
Provider Enumeration Date:
02/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KASHYAP
Authorized Official First Name:
BANSHI
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
913-236-4500

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  04-17448 , 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)