Provider Demographics
NPI:1770766982
Name:HEALTH ADMINISOURCE, LLC
Entity type:Organization
Organization Name:HEALTH ADMINISOURCE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-226-4011
Mailing Address - Street 1:7932 N OAK TRFY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-1423
Mailing Address - Country:US
Mailing Address - Phone:816-436-4500
Mailing Address - Fax:816-436-4510
Practice Address - Street 1:7932 N OAK TRFY
Practice Address - Street 2:SUITE 212
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-1423
Practice Address - Country:US
Practice Address - Phone:816-436-4500
Practice Address - Fax:816-436-4510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE3095OtherMEDICARE RAILROAD
440660OtherHEALTHLINK
731060OtherHEALTHCARE PREFERRED
MO14112991OtherU.S. DEPT OF LABOR
266626OtherMEDICARE PART A
MOT660000AOtherMEDICARE PART B
16278037OtherBLUE CROSS BLUE SHIELD
4000127OtherMULTIPLAN
KS534021OtherBLUE CROSS BLUE SHIELD KS
8271336OtherAETNA