1750300851 NPI number — OSTOMY CARE CENTER INC

Table of content: (NPI 1750300851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750300851 NPI number — OSTOMY CARE CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OSTOMY CARE CENTER INC
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:
1750300851
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 WEST 39 STREET
Provider Second Line Business Mailing Address:
OSTOMY CARE CENTER INS
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64111-2218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-753-6446
Provider Business Mailing Address Fax Number:
816-753-2317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 WEST 39 STREET
Provider Second Line Business Practice Location Address:
OSTOMY CARE CENTER INS
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64111-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-753-6446
Provider Business Practice Location Address Fax Number:
816-753-2317
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PESCETTO
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
FRANKLIN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
816-753-6446

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com