MEDICARE: SPECTRUM HEALTH FOUNDATION

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	332BX2000X	Oxygen Equipment & Supplies (DME)	01980-000000-00579	KS

General Provider Information

NPI Number	:	1720082050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM HEALTH FOUNDATION

Provider Business Mailing Address
First Line	:	2915 STRONG AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66106-2144
Country	:	US
Telephone Number	:	913-831-2979
Fax Number	:	913-831-9566

Provider Business Practice Location Address
First Line	:	2915 STRONG AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66106-2144
Country	:	US
Telephone Number	:	913-831-2979
Fax Number	:	913-831-9566

Authorized Official
Title or Position	:	HME MANAGER
Name	:	MR. FRANCISCO L LOPEZ
Credential	:	CRT
Telephone Number	:	913-831-2979

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	08/22/2020

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Directions to “SPECTRUM HEALTH FOUNDATION ” Practice Location

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