MEDICARE: UNIVERSITY OF KANSAS HOSPITAL AUTHORITY

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
1	3336C0003X	Community/Retail Pharmacy	204345	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2031345	OTHER	PK

General Provider Information

NPI Number	:	1457335036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF KANSAS HOSPITAL AUTHORITY

Provider Business Mailing Address
First Line	:	PO BOX 955772
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-5772
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:	913-588-2385

Provider Business Practice Location Address
First Line	:	4000 CAMBRIDGE STREET MAILSTOP 4040
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8501
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:	913-588-2385

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BOB PAGE
Credential	:
Telephone Number	:	913-588-1227

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/29/2024

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Directions to “UNIVERSITY OF KANSAS HOSPITAL AUTHORITY ” Practice Location

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