Healthcare Provider Details

I. General information

NPI: 1801379003
Provider Name (Legal Business Name): AXIVARX OF KANSAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11425 STRANG LINE RD
LENEXA KS
66215-4047
US

IV. Provider business mailing address

11425 STRANG LINE RD
LENEXA KS
66215-4047
US

V. Phone/Fax

Practice location:
  • Phone: 913-355-5600
  • Fax: 913-355-5601
Mailing address:
  • Phone: 913-355-5600
  • Fax: 913-355-5601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN S SHAPIRO
Title or Position: PRESIDENT
Credential:
Phone: 844-442-9482