1700395878 NPI number — UNIVERSITY OF KANSAS HOSPITAL AUTHORITY

Table of content: (NPI 1700395878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700395878 NPI number — UNIVERSITY OF KANSAS HOSPITAL AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF KANSAS HOSPITAL AUTHORITY
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:
6
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:
1700395878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 RAINBOW BLVD
Provider Second Line Business Mailing Address:
MAIL STOP 4040
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66160-8500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-2361
Provider Business Mailing Address Fax Number:
913-588-2385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3825 CAMBRIDGE ST
Provider Second Line Business Practice Location Address:
STE 1333
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66103-2883
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-574-3100
Provider Business Practice Location Address Fax Number:
913-574-3182
Provider Enumeration Date:
09/21/2017

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
JAMIE
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT DIRECTOR
Authorized Official Telephone Number:
785-760-3318

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  2103863 , 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)





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