Healthcare Provider Details
I. General information
NPI: 1528016482
Provider Name (Legal Business Name): JAYHAWK PRIMARY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6515 N COSBY AVE PICTURE HILLS AFTER HOURS URGENT CARE
KANSAS CITY MO
64151-2380
US
IV. Provider business mailing address
2330 SHAWNEE MISSION PKWY MEDICAL ADNINISTRATIVE SERVICES OF KU MED. STE. 312
WESTWOOD KS
66205-2005
US
V. Phone/Fax
- Phone: 816-505-5050
- Fax: 816-587-7708
- Phone: 913-588-9000
- Fax: 913-588-9822
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAMELA
J.
MYRTLE
Title or Position: HR DIRECTOR
Credential:
Phone: 913-588-9808