Provider Demographics
NPI:1669464426
Name:DIAGNOSTIC RADIOLOGY INSTITUTE OF KANSAS CITY, INC.
Entity Type:Organization
Organization Name:DIAGNOSTIC RADIOLOGY INSTITUTE OF KANSAS CITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERWANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-831-0509
Mailing Address - Street 1:6444 METCALF AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3950
Mailing Address - Country:US
Mailing Address - Phone:913-831-0509
Mailing Address - Fax:913-831-0439
Practice Address - Street 1:6444 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-3950
Practice Address - Country:US
Practice Address - Phone:913-831-0509
Practice Address - Fax:913-831-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS9004264Medicare ID - Type Unspecified