Provider Demographics
NPI:1114042512
Name:KANSAS STATE UNIVERISTY
Entity Type:Organization
Organization Name:KANSAS STATE UNIVERISTY
Other - Org Name:RABIES LABORATORY DEPT OF VET DIAGNOSIS
Other - Org Type:Other Name
Authorized Official - Title/Position:DEPARTMENT HEAD
Authorized Official - Prefix:DR
Authorized Official - First Name:MM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENGAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:785-532-4401
Mailing Address - Street 1:1800 DENISON AVE
Mailing Address - Street 2:MOSIER HALL
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66506-5660
Mailing Address - Country:US
Mailing Address - Phone:785-532-4483
Mailing Address - Fax:785-532-4474
Practice Address - Street 1:1800 DENISON AVE
Practice Address - Street 2:MOSIER HALL
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66506-5660
Practice Address - Country:US
Practice Address - Phone:785-532-4483
Practice Address - Fax:785-532-4474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory