Provider Demographics
NPI:1245470947
Name:ACUITY HOSPITAL OF KANSAS. LLC
Entity type:Organization
Organization Name:ACUITY HOSPITAL OF KANSAS. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-887-7283
Mailing Address - Street 1:10150 MALLARD CREEK RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-9708
Mailing Address - Country:US
Mailing Address - Phone:704-887-7283
Mailing Address - Fax:
Practice Address - Street 1:8080 E PAWNEE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5475
Practice Address - Country:US
Practice Address - Phone:316-682-0004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH087007282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200539570AMedicaid
KS200539570AMedicaid