Provider Demographics
NPI:1497531537
Name:ARCHWAY CLINICS LLC
Entity Type:Organization
Organization Name:ARCHWAY CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:G
Authorized Official - Last Name:MELESIO
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:224-337-8925
Mailing Address - Street 1:7180 W 107TH ST STE 11
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2523
Mailing Address - Country:US
Mailing Address - Phone:224-337-8925
Mailing Address - Fax:
Practice Address - Street 1:7180 W 107TH ST STE 11
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2523
Practice Address - Country:US
Practice Address - Phone:224-337-8925
Practice Address - Fax:816-912-1739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center