Healthcare Provider Details

I. General information

NPI: 1023627940
Provider Name (Legal Business Name): ARENA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 STATELINE ROAD SUITE 100
PRAIRIE VILLAGE KS
66208
US

IV. Provider business mailing address

8010 STATELINE ROAD SUITE 100
PRAIRIE VILLAGE KS
66208
US

V. Phone/Fax

Practice location:
  • Phone: 816-830-4285
  • Fax:
Mailing address:
  • Phone: 816-830-4285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. OMKAR VAIDYA U. VAIDYA
Title or Position: MD/OWNER
Credential: MD
Phone: 816-588-0725