MEDICARE: 4M HEALTHCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory		KS

General Provider Information

NPI Number	:	1831612670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	4M HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	10909 S CLAY BLAIR BLVD
Second Line	:	SUITE 1500
City	:	OLATHE
State	:	KS
Zip	:	66061
Country	:	US
Telephone Number	:	913-222-5600
Fax Number	:	913-222-5601

Provider Business Practice Location Address
First Line	:	15110 GLENWOOD AVE
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66223-3338
Country	:	US
Telephone Number	:	913-222-5600
Fax Number	:	913-222-5601

Authorized Official
Title or Position	:	CEO
Name	:	MR. JERRED MANN
Credential	:
Telephone Number	:	913-222-5600

Provider Enumeration Date	:	07/24/2017
Last Update Date	:	07/21/2022

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