Provider Demographics
NPI:1912014929
Name:MERCY KANSAS COMMUNITIES INC
Entity Type:Organization
Organization Name:MERCY KANSAS COMMUNITIES INC
Other - Org Name:OUTPATIENT CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-625-2459
Mailing Address - Street 1:800 W MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-3240
Mailing Address - Country:US
Mailing Address - Phone:620-331-2200
Mailing Address - Fax:
Practice Address - Street 1:800 W LAUREL ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-3211
Practice Address - Country:US
Practice Address - Phone:620-331-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY KANSAS COMMUNITIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-24
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-063-004261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care