Provider Demographics
NPI:1104036847
Name:COMMUNITY BLOOD CENTER OF GREATER KANSAS CITY
Entity Type:Organization
Organization Name:COMMUNITY BLOOD CENTER OF GREATER KANSAS CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENITOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-753-4040
Mailing Address - Street 1:4040 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2308
Mailing Address - Country:US
Mailing Address - Phone:816-753-4040
Mailing Address - Fax:816-968-4430
Practice Address - Street 1:4040 MAIN ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2308
Practice Address - Country:US
Practice Address - Phone:816-753-4040
Practice Address - Fax:816-968-4430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes331L00000XSuppliersBlood Bank