Provider Demographics
NPI:1649376757
Name:ADS HEALTHCARE LLC
Entity type:Organization
Organization Name:ADS HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FACILITY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALBERS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:913-661-1755
Mailing Address - Street 1:6901 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2007
Mailing Address - Country:US
Mailing Address - Phone:913-661-1755
Mailing Address - Fax:913-661-9260
Practice Address - Street 1:6901 W 121ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2007
Practice Address - Country:US
Practice Address - Phone:913-661-1755
Practice Address - Fax:913-661-9260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSS-046-013261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
9004085Medicare PIN
17-C0001044Medicare ID - Type Unspecified
9004085Medicare PIN