Provider Demographics
NPI:1558387159
Name:GERIATRIC HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:GERIATRIC HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GRINDSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-276-6450
Mailing Address - Street 1:8301 STATE LINE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2025
Mailing Address - Country:US
Mailing Address - Phone:816-276-6450
Mailing Address - Fax:816-276-6455
Practice Address - Street 1:8301 STATE LINE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2025
Practice Address - Country:US
Practice Address - Phone:816-276-6450
Practice Address - Fax:816-276-6455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSCD6105Medicare PIN
KS110304Medicare PIN
MOH200000Medicare ID - Type Unspecified
MOH200000AMedicare ID - Type Unspecified
MOH200000BMedicare ID - Type Unspecified
MOCD6103Medicare PIN
MOH200000DMedicare ID - Type Unspecified
MOH200000CMedicare ID - Type Unspecified