Provider Demographics
NPI:1750300851
Name:OSTOMY CARE CENTER INC
Entity Type:Organization
Organization Name:OSTOMY CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:PESCETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-753-6446
Mailing Address - Street 1:102 WEST 39 STREET
Mailing Address - Street 2:OSTOMY CARE CENTER INS
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2218
Mailing Address - Country:US
Mailing Address - Phone:816-753-6446
Mailing Address - Fax:816-753-2317
Practice Address - Street 1:102 WEST 39 STREET
Practice Address - Street 2:OSTOMY CARE CENTER INS
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2218
Practice Address - Country:US
Practice Address - Phone:816-753-6446
Practice Address - Fax:816-753-2317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0248340001Medicare ID - Type Unspecified