Provider Demographics
NPI:1811923022
Name:KANSAS CITY HEALTH SYSTEMS, INC
Entity type:Organization
Organization Name:KANSAS CITY HEALTH SYSTEMS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANHOLTZER
Authorized Official - Suffix:
Authorized Official - Credentials:RNC, MSN, WHNP
Authorized Official - Phone:816-525-0907
Mailing Address - Street 1:324 NW CAPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-4723
Mailing Address - Country:US
Mailing Address - Phone:816-525-0907
Mailing Address - Fax:816-525-1664
Practice Address - Street 1:324 NW CAPITAL DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4723
Practice Address - Country:US
Practice Address - Phone:816-525-0907
Practice Address - Fax:816-525-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100445050AMedicaid
MO625309802Medicaid
MO4136460001Medicare NSC