Provider Demographics
NPI:1083048672
Name:AUTHENTIC MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:AUTHENTIC MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-393-1866
Mailing Address - Street 1:6625 MILHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4213
Mailing Address - Country:US
Mailing Address - Phone:785-393-1866
Mailing Address - Fax:
Practice Address - Street 1:6625 MILHAVEN DR
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-4213
Practice Address - Country:US
Practice Address - Phone:785-393-1866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory