Healthcare Provider Details

I. General information

NPI: 1215241880
Provider Name (Legal Business Name): ERICKSON HEALTH MEDICAL GROUP OF KANSAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13800 METCALF AVE
OVERLAND PARK KS
66223-1200
US

IV. Provider business mailing address

5525 RESEARCH PARK DR 4TH FLOOR
BALTIMORE MD
21228-4664
US

V. Phone/Fax

Practice location:
  • Phone: 913-945-2080
  • Fax: 913-945-2095
Mailing address:
  • Phone: 913-945-2080
  • Fax: 913-945-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW J NARRETT
Title or Position: PRESIDENT
Credential: MD
Phone: 410-402-2261