Healthcare Provider Details

I. General information

NPI: 1982827523
Provider Name (Legal Business Name): SARADIH HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10951 LAKEVIEW AVE STE A
LENEXA KS
66219-1331
US

IV. Provider business mailing address

9744 SUNSET CIR
LENEXA KS
66220-3726
US

V. Phone/Fax

Practice location:
  • Phone: 913-553-0945
  • Fax: 913-701-3323
Mailing address:
  • Phone: 913-742-3363
  • Fax: 913-825-6358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WADDAH Y GHOSHEH
Title or Position: BUSINESS MANAGER
Credential:
Phone: 913-634-3540