Provider Demographics
NPI:1477508323
Name:VILLAGE PEDIATRICS, LLC
Entity Type:Organization
Organization Name:VILLAGE PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CHERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-642-2100
Mailing Address - Street 1:8340 MISSION RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66206-1355
Mailing Address - Country:US
Mailing Address - Phone:913-642-2100
Mailing Address - Fax:913-642-2127
Practice Address - Street 1:8340 MISSION RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66206-1355
Practice Address - Country:US
Practice Address - Phone:913-642-2100
Practice Address - Fax:913-642-2127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty