Provider Demographics
NPI:1598206534
Name:KANSAS MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:KANSAS MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-384-0458
Mailing Address - Street 1:435 NICHOLS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2036
Mailing Address - Country:US
Mailing Address - Phone:816-384-0458
Mailing Address - Fax:316-530-8050
Practice Address - Street 1:435 NICHOLS RD STE 200
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-2036
Practice Address - Country:US
Practice Address - Phone:816-384-0458
Practice Address - Fax:316-530-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies