1770766982 NPI number — HEALTH ADMINISOURCE, LLC

Table of content: (NPI 1770766982)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770766982 NPI number — HEALTH ADMINISOURCE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH ADMINISOURCE, 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:
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:
1770766982
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7932 N OAK TRFY
Provider Second Line Business Mailing Address:
SUITE 212
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64118-1423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-436-4500
Provider Business Mailing Address Fax Number:
816-436-4510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7932 N OAK TRFY
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64118-1423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-436-4500
Provider Business Practice Location Address Fax Number:
816-436-4510
Provider Enumeration Date:
12/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DUNCAN
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
816-226-4011

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DE3095 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 440660 . This is a "HEALTHLINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 731060 . This is a "HEALTHCARE PREFERRED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 14112991 . This is a "U.S. DEPT OF LABOR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 266626 . This is a "MEDICARE PART A" identifier . This identifiers is of the category "OTHER".
  • Identifier: T660000A . This is a "MEDICARE PART B" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 16278037 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4000127 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 534021 . This is a "BLUE CROSS BLUE SHIELD KS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 8271336 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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