Provider Demographics
NPI:1821551292
Name:STONERIDGE INVESTMENTS
Entity Type:Organization
Organization Name:STONERIDGE INVESTMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:NBC-HIS
Authorized Official - Phone:316-650-8343
Mailing Address - Street 1:11006 W TAYLOR CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-5483
Mailing Address - Country:US
Mailing Address - Phone:316-650-8343
Mailing Address - Fax:
Practice Address - Street 1:2715 CANDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6653
Practice Address - Country:US
Practice Address - Phone:620-342-4327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
1457772857OtherNPPES