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General NPI Number Information
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NPI Number | 1104036847
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Entity Type | Organization
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Legal Business Name | COMMUNITY BLOOD CENTER OF GREATER KANSAS CITY
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4040 MAIN ST
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City | KANSAS CITY
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State | MO
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Zip | 64111-2308
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Country | US
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Telephone | 816-753-4040
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Fax | 816-968-4430
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Provider Business Mailing Address
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Address Line | 4040 MAIN ST
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City | KANSAS CITY
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State | MO
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Zip | 64111-2308
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Country | US
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Telephone | 816-753-4040
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Fax | 816-968-4430
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Authorized Official
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Title or Position | MEDICAL DIRECTOR EXECUTIVE DIRECTOR
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Name | DR. JAY E MENITOVE
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Credential | M.D.
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Telephone | 816-753-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 331L00000X
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Taxonomy Name | Blood Bank
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License Number |
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License Number State |
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