Provider Demographics
NPI:1437377140
Name:ADVANTAGE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANTAGE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-234-4679
Mailing Address - Street 1:11131 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1482
Mailing Address - Country:US
Mailing Address - Phone:913-234-4649
Mailing Address - Fax:913-234-4644
Practice Address - Street 1:11131 W 79TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1482
Practice Address - Country:US
Practice Address - Phone:913-234-4649
Practice Address - Fax:913-234-4644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1139630001Medicare ID - Type Unspecified