Healthcare Provider Details

I. General information

NPI: 1801028634
Provider Name (Legal Business Name): MEDICAL WEST RESPIRATORY CENTRAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15502 COLLEGE BLVD
LENEXA KS
66219-1350
US

IV. Provider business mailing address

9301 DIELMAN INDUSTRIAL D
SAINT LOUIS MO
63132-2204
US

V. Phone/Fax

Practice location:
  • Phone: 913-888-2500
  • Fax: 913-888-2503
Mailing address:
  • Phone: 314-993-8100
  • Fax: 314-993-8101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL K LANE JR.
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 314-993-7900