MEDICARE: SCHOOL DISTRICT OF KANSAS CITY,MISSOURI

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	261QS1000X	Student Health Clinic/Center

General Provider Information

NPI Number	:	1972752152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOOL DISTRICT OF KANSAS CITY,MISSOURI

Provider Business Mailing Address
First Line	:	1215 E TRUMAN RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64106-3152
Country	:	US
Telephone Number	:	816-418-8649
Fax Number	:

Provider Business Practice Location Address
First Line	:	3221 INDIANA AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64128-2062
Country	:	US
Telephone Number	:	816-418-2080
Fax Number	:	816-418-2079

Authorized Official
Title or Position	:	MANAGER, SCHOOL BASED SCHOOL LINKED
Name	:	FELICIA SAFIR
Credential	:
Telephone Number	:	816-418-8647

Provider Enumeration Date	:	09/12/2008
Last Update Date	:	09/12/2008

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