Healthcare Provider Details

I. General information

NPI: 1053519223
Provider Name (Legal Business Name): UNIVERSITY OF KANSAS HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 STATE AVE PROFESSIONAL SERVICES OF KU HOSPITAL
KANSAS CITY KS
66102-1748
US

IV. Provider business mailing address

2330 SHAWNEE MISSION PKWY MEDICAL ADMINISTRATIVE SERVICES OF KU MED STE 312
WESTWOOD KS
66205-2005
US

V. Phone/Fax

Practice location:
  • Phone: 913-321-4567
  • Fax: 913-321-6789
Mailing address:
  • Phone: 913-945-5614
  • Fax: 913-945-5599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAMMY SHEPHERD
Title or Position: CFO
Credential:
Phone: 913-945-5596