Healthcare Provider Details

I. General information

NPI: 1083488258
Provider Name (Legal Business Name): CLINICAL SOLUTIONS KANSAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4615 N CYPRESS ST STE 150
BEL AIRE KS
67226-8836
US

IV. Provider business mailing address

416 MARY LINDSAY POLK DR STE 515
FRANKLIN TN
37067-6212
US

V. Phone/Fax

Practice location:
  • Phone: 316-202-6360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KATHY DERBY
Title or Position: MANAGER
Credential:
Phone: 402-450-7100