Provider Demographics
NPI:1679803183
Name:MIDWEST HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:MIDWEST HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHADFAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-663-9930
Mailing Address - Street 1:8500 W 110TH ST STE 600
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1860
Mailing Address - Country:US
Mailing Address - Phone:913-663-9930
Mailing Address - Fax:800-590-5269
Practice Address - Street 1:8500 W 110TH ST STE 600
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210
Practice Address - Country:US
Practice Address - Phone:913-663-9930
Practice Address - Fax:800-590-5269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA046183251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care