Provider Demographics
NPI:1073608220
Name:G I D HOLDINGS, INC
Entity Type:Organization
Organization Name:G I D HOLDINGS, INC
Other - Org Name:GI DIAGNOSTICS, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-561-2000
Mailing Address - Street 1:4321 WASHINGTON ST
Mailing Address - Street 2:SUITE 5700
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5961
Mailing Address - Country:US
Mailing Address - Phone:816-561-2000
Mailing Address - Fax:
Practice Address - Street 1:4321 WASHINGTON ST
Practice Address - Street 2:SUITE 5700
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5961
Practice Address - Country:US
Practice Address - Phone:816-561-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO42-16OtherSTATE LICENSE
MO8500020Medicare ID - Type Unspecified