Healthcare Provider Details

I. General information

NPI: 1073608220
Provider Name (Legal Business Name): G I D HOLDINGS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 WASHINGTON ST SUITE 5700
KANSAS CITY MO
64111-5961
US

IV. Provider business mailing address

4321 WASHINGTON ST SUITE 5700
KANSAS CITY MO
64111-5961
US

V. Phone/Fax

Practice location:
  • Phone: 816-561-2000
  • Fax:
Mailing address:
  • Phone: 816-561-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE ROBERTS
Title or Position: OFFICE MANAGER
Credential:
Phone: 816-561-2000