Provider Demographics
NPI:1710070388
Name:KANSAS SPECIALTY SERVICES, INC.
Entity Type:Organization
Organization Name:KANSAS SPECIALTY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-221-6040
Mailing Address - Street 1:814 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-2835
Mailing Address - Country:US
Mailing Address - Phone:620-221-6040
Mailing Address - Fax:620-221-6041
Practice Address - Street 1:814 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-2835
Practice Address - Country:US
Practice Address - Phone:620-221-6040
Practice Address - Fax:620-221-6041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS118009OtherBCBS PROVIDER NUMBER
KS506996OtherHPK PROVIDER NUMBER
KS100443340AMedicaid
KS6827OtherPPK PROVIDER NUMBER
KS506996OtherHPK PROVIDER NUMBER