Provider Demographics
NPI:1770633000
Name:KANSAS DIALYSIS SERVICES
Entity Type:Organization
Organization Name:KANSAS DIALYSIS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:F
Authorized Official - Last Name:LANGHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-234-2277
Mailing Address - Street 1:634 SW MULVANE
Mailing Address - Street 2:SUITE #300
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1678
Mailing Address - Country:US
Mailing Address - Phone:785-234-2277
Mailing Address - Fax:785-234-2396
Practice Address - Street 1:634 SW MULVANE
Practice Address - Street 2:SUITE #300
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1678
Practice Address - Country:US
Practice Address - Phone:785-234-2277
Practice Address - Fax:785-234-2396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
172508Medicare ID - Type Unspecified