=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093500944
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GETASEW BAYE LEGASIE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2025
-----------------------------------------------------
Last Update Date | 04/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 921 S CLEARWATER HILLS ST
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66061-5263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-850-3879
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 921 S CLEARWATER HILLS ST
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66061-5263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-850-3879
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 342000000X
-----------------------------------------------------
Taxonomy Name | Transportation Network Company
-----------------------------------------------------
License Number | 952SCG
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------