Healthcare Provider Details

I. General information

NPI: 1710094271
Provider Name (Legal Business Name): MERCY KANSAS COMMUNITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 02/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MYRTLE ST
INDEPENDENCE KS
67301-3240
US

IV. Provider business mailing address

800 W MYRTLE ST
INDEPENDENCE KS
67301-3240
US

V. Phone/Fax

Practice location:
  • Phone: 620-331-2200
  • Fax: 620-332-3270
Mailing address:
  • Phone: 620-331-2200
  • Fax: 620-332-3270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License NumberH-063-004
License Number StateKS

VIII. Authorized Official

Name: SHELLY HUNTER
Title or Position: CFO
Credential:
Phone: 417-625-2459