Healthcare Provider Details

I. General information

NPI: 1225372360
Provider Name (Legal Business Name): BIZI4, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 WIMBLEDON DR
LAWRENCE KS
66047-1951
US

IV. Provider business mailing address

4420 WIMBLEDON DR
LAWRENCE KS
66047-1951
US

V. Phone/Fax

Practice location:
  • Phone: 785-841-5627
  • Fax:
Mailing address:
  • Phone: 785-841-5627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. HUMAYUN M AHMED
Title or Position: PRESIDENT
Credential:
Phone: 785-312-0659