Archway Clinics Llc | |
7180 W 107th St Ste 11 Overland Park KS 66212-2523 | |
(224) 337-8925 | |
(816) 912-1739 |
Full Name | Archway Clinics Llc |
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Speciality | Clinic/Center |
Location | 7180 W 107th St Ste 11, Overland Park, Kansas |
Authorized Official Name and Position | Marcus G Melesio (OWNER) |
Authorized Official Contact | 2243378925 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Archway Clinics Llc 7180 W 107th St Ste 11 Overland Park KS 66212-2523 Ph: (224) 337-8925 | Archway Clinics Llc 7180 W 107th St Ste 11 Overland Park KS 66212-2523 Ph: (224) 337-8925 |
NPI Number | 1497531537 |
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Provider Enumeration Date | 09/05/2023 |
Last Update Date | 11/21/2023 |
Medicare PECOS PAC ID | 0749626695 |
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Medicare Enrollment ID | O20240313003159 |
Identifier | Type | State | Issuer |
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1497531537 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Ashley Henry |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1538542642 PECOS PAC ID: 6305173279 Enrollment ID: I20190815000473 |
Provider Name | Emeka Ogwudile |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538690920 PECOS PAC ID: 3678847175 Enrollment ID: I20200311001224 |
Provider Name | Trace Yule |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720586621 PECOS PAC ID: 0749541324 Enrollment ID: I20240613003500 |
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