Healthcare Provider Details

I. General information

NPI: 1568305647
Provider Name (Legal Business Name): IHPER KS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 S 4TH ST
LEAVENWORTH KS
66048-5043
US

IV. Provider business mailing address

350 SENTRY PARKWAY BUILDING 660 SUITE 102
BLUE BELL PA
19422
US

V. Phone/Fax

Practice location:
  • Phone: 484-965-9566
  • Fax: 484-965-9567
Mailing address:
  • Phone: 484-965-9566
  • Fax: 484-965-9567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM VEMULA
Title or Position: CO-CEO
Credential: MD
Phone: 484-965-9566