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General NPI Number Information
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NPI Number | 1386166536
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Entity Type | Organization
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Legal Business Name | MID STAR LAB INC
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 406 W 34TH ST STE 710
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City | KANSAS CITY
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State | MO
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Zip | 64111-7511
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Country | US
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Telephone | 816-839-4771
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 COMMERCE RD
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City | TONGANOXIE
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State | KS
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Zip | 66086-5369
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Country | US
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Telephone | 913-369-8734
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KARI WAGNER
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Credential | C. PED
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Telephone | 913-369-8734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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