Healthcare Provider Details

I. General information

NPI: 1851463624
Provider Name (Legal Business Name): OLATHE CANCER CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20375 W 151ST ST SUITE 208
OLATHE KS
66061-7218
US

IV. Provider business mailing address

20375 W 151ST ST SUITE 208
OLATHE KS
66061-7218
US

V. Phone/Fax

Practice location:
  • Phone: 913-780-4000
  • Fax: 913-780-4038
Mailing address:
  • Phone: 913-780-4000
  • Fax: 913-780-4038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number0430533
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0420572
License Number StateKS

VIII. Authorized Official

Name: MRS. MELODIE J SCHMIDT
Title or Position: OFFICE MANAGER
Credential:
Phone: 913-780-4000