Healthcare Provider Details

I. General information

NPI: 1588528798
Provider Name (Legal Business Name): UNIVERSAL CONNECTION HEALTHCARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14415 BRISTOL AVE
GRANDVIEW MO
64030-4103
US

IV. Provider business mailing address

14415 BRISTOL AVE
GRANDVIEW MO
64030-4103
US

V. Phone/Fax

Practice location:
  • Phone: 816-585-7657
  • Fax:
Mailing address:
  • Phone: 816-585-7657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. TRISEANA EDWARDS
Title or Position: OWNER/PHLEBOTOMIST
Credential:
Phone: 816-585-7657