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NPI Code Detail

MEDICARE: KANSAS CITY SOUTH MO CONSULTING LLC

MEDICARE: KANSAS CITY SOUTH MO CONSULTING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1356936223
Entity Type Code : Organization
Provider Name (Legal Business Name) : KANSAS CITY SOUTH MO CONSULTING LLC
Provider Business Mailing Address
First Line : 525 CHESTNUT ST STE 102
Second Line :
City : CEDARHURST
State : NY
Zip : 11516-2223
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8033 HOLMES RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64131-2115
Country : US
Telephone Number : 816-363-6222
Fax Number :
Authorized Official
Title or Position : AUTHORIZED PERSON
Name : SAMUEL GOLDNER
Credential :
Telephone Number : 516-727-1634
Provider Enumeration Date : 03/03/2021
Last Update Date : 09/16/2022

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Directions to “KANSAS CITY SOUTH MO CONSULTING LLC ” Practice Location

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