Healthcare Provider Details

I. General information

NPI: 1841699808
Provider Name (Legal Business Name): DOCTORS EQUIPMENT SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 TROOST AVE
KANSAS CITY MO
64110-3147
US

IV. Provider business mailing address

6021 TROOST AVE
KANSAS CITY MO
64110-3147
US

V. Phone/Fax

Practice location:
  • Phone: 816-523-6644
  • Fax: 816-444-6807
Mailing address:
  • Phone: 816-523-6644
  • Fax: 816-444-6807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number900987
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number16-4415
License Number StateKS

VIII. Authorized Official

Name: SUZANNE DUEWEL
Title or Position: MANAGER
Credential:
Phone: 816-523-6644