Healthcare Provider Details

I. General information

NPI: 1700609518
Provider Name (Legal Business Name): ACG KANSAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 W 132ND ST STE 180B
OVERLAND PARK KS
66213-1147
US

IV. Provider business mailing address

187 N CHURCH ST STE 201
SPARTANBURG SC
29306-5154
US

V. Phone/Fax

Practice location:
  • Phone: 800-932-2738
  • Fax: 888-239-2595
Mailing address:
  • Phone: 800-932-2738
  • Fax: 888-847-9306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA DUNCAN OWENS
Title or Position: CCO
Credential:
Phone: 800-932-2738