Provider Demographics
NPI:1720272289
Name:UNIVERSITY OF KANSAS HOSPITAL AUTHOURITY
Entity Type:Organization
Organization Name:UNIVERSITY OF KANSAS HOSPITAL AUTHOURITY
Other - Org Name:PROFESSIONAL SERVICES OF KU HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-915-5596
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-945-5614
Mailing Address - Fax:
Practice Address - Street 1:501 W 107TH ST
Practice Address - Street 2:GRAND COURT ONE OF KANSAS CITY
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5919
Practice Address - Country:US
Practice Address - Phone:913-321-4567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health