1336282573 NPI number — COMPREHENSIVE HEALTH OF PLANNED PARENTHOOD GREAT PLAINS

Table of content: (NPI 1336282573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336282573 NPI number — COMPREHENSIVE HEALTH OF PLANNED PARENTHOOD GREAT PLAINS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPREHENSIVE HEALTH OF PLANNED PARENTHOOD GREAT PLAINS
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:
1336282573
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401 W 109TH ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66211-1303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-312-1400
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4401 W 109TH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66211-1303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-345-1400
Provider Business Practice Location Address Fax Number:
913-469-3655
Provider Enumeration Date:
02/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PARKS
Authorized Official First Name:
VICTORIA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF HEALTH SERVICES OPS
Authorized Official Telephone Number:
918-587-4621

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 09841028 . This is a "BCBS OF KC DR ID #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 05543013 . This is a "BCBS OF KC GROUP ID#" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 200282660B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 209208404 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100308570B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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