Healthcare Provider Details

I. General information

NPI: 1457335036
Provider Name (Legal Business Name): UNIVERSITY OF KANSAS HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE STREET MAILSTOP 4040
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

PO BOX 955772
SAINT LOUIS MO
63195-5772
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax: 913-588-2385
Mailing address:
  • Phone: 913-588-1227
  • Fax: 913-588-2385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number204345
License Number StateKS

VIII. Authorized Official

Name: BOB PAGE
Title or Position: PRESIDENT
Credential:
Phone: 913-588-1227