Healthcare Provider Details

I. General information

NPI: 1609994623
Provider Name (Legal Business Name): WORLD MIDWEST SURGICAL ASSIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 HUTTON RD SUITE 105
KANSAS CITY KS
66109-4564
US

IV. Provider business mailing address

2040 HUTTON RD SUITE 105
KANSAS CITY KS
66109-4564
US

V. Phone/Fax

Practice location:
  • Phone: 913-299-9540
  • Fax: 888-329-6432
Mailing address:
  • Phone: 913-299-9540
  • Fax: 888-329-6432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number StateKS

VIII. Authorized Official

Name: PATRICK MULLENDORE
Title or Position: PRESIDENT
Credential: SFA
Phone: 913-299-9540