Provider Demographics
NPI:1598105603
Name:ADVANCED RADIATION CENTER OF KANSAS CITY LLC
Entity Type:Organization
Organization Name:ADVANCED RADIATION CENTER OF KANSAS CITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHARLACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-589-6879
Mailing Address - Street 1:6565 WEST LOOP S
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3500
Mailing Address - Country:US
Mailing Address - Phone:713-589-6879
Mailing Address - Fax:713-863-8308
Practice Address - Street 1:6427 W 119TH ST
Practice Address - Street 2:SUITE G 1-4
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2734
Practice Address - Country:US
Practice Address - Phone:913-202-1700
Practice Address - Fax:913-202-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04364832085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty