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General NPI Number Information
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NPI Number | 1194059907
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Entity Type | Organization
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Legal Business Name | BAYER HEALTHCARE, ANIMAL HEALTH DIV OHN
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 12809 W 63RD ST PO 390
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City | SHAWNEE
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State | KS
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Zip | 66216-1848
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Country | US
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Telephone | 913-268-2731
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Fax | 913-268-2725
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Provider Business Mailing Address
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Address Line | 12809 W 63RD PO 390
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City | SHAWNEE
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State | KS
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Zip | 66219
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Country | US
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Telephone | 913-268-2731
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Fax | 913-268-2725
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Authorized Official
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Title or Position | OCCUPATIONAL HEALTH NURSE
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Name | MR. DONALD J NANNEMAN
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Credential | RN
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Telephone | 913-268-2731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 14-58087-042
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License Number State | KS
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