1174649164 NPI number — FARNEY CHIROPRACTIC CLINIC

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 1174649164 NPI number — FARNEY CHIROPRACTIC CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARNEY CHIROPRACTIC CLINIC
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:
1174649164
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:
215 S ANDOVER RD
Provider Second Line Business Mailing Address:
BOX 910 STE C
Provider Business Mailing Address City Name:
ANDOVER
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67002-7919
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-733-2429
Provider Business Mailing Address Fax Number:
316-733-2510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 S ANDOVER RD
Provider Second Line Business Practice Location Address:
BOX 910 STE C
Provider Business Practice Location Address City Name:
ANDOVER
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67002-7919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-733-2429
Provider Business Practice Location Address Fax Number:
316-733-2510
Provider Enumeration Date:
03/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FARNEY
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
LOUIS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
316-733-2429

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  01-03608 , 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: 60946 . This is a "BCBS CAP PROGRAM" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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