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General NPI Number Information
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NPI Number | 1417090275
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Entity Type | Organization
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Legal Business Name | KANSAS CITY CANCER CENTER
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12200 W 110TH ST
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City | OVERLAND PARK
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State | KS
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Zip | 66210-4045
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Country | US
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Telephone | 913-234-0475
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Fax | 913-234-0570
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Provider Business Mailing Address
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Address Line | 9200 INDIAN CREEK PKWY BUILDING 9 SUITE 300
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City | OVERLAND PARK
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State | KS
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Zip | 66210-2002
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Country | US
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Telephone | 913-541-4600
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Fax | 913-577-5851
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Authorized Official
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Title or Position | PRACTICE DIRECTOR
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Name | MR. JOHN HENNESSY
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Credential |
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Telephone | 913-541-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2-09763
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License Number State | KS
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