1568684017 NPI number — RESEARCH NEUROLOGY ASSOCIATES, LLC

Table of content: (NPI 1568684017)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568684017 NPI number — RESEARCH NEUROLOGY ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESEARCH NEUROLOGY ASSOCIATES, LLC
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:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1568684017
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 E MEYER BLVD
Provider Second Line Business Mailing Address:
SUITE 401
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64132-1132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-756-2651
Provider Business Mailing Address Fax Number:
816-756-2655

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2330 E MEYER BLVD
Provider Second Line Business Practice Location Address:
SUITE 401
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64132-1132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-756-2651
Provider Business Practice Location Address Fax Number:
816-756-2655
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MILLS
Authorized Official First Name:
NISHA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
816-756-2651

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200517320A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 505478602 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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