| Kidscare Leavenworth Pediatrics | |
|
1001 6th Ave Ste 210 Leavenworth KS 66048-3248 | |
| (816) 923-5800 | |
| Not Available |
| Full Name | Kidscare Leavenworth Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 1001 6th Ave Ste 210, Leavenworth, Kansas |
| Authorized Official Name and Position | Essence Mongtomery (CFO) |
| Authorized Official Contact | 8165995683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidscare Leavenworth Pediatrics 3801 Dr Martin Luther King Jr Blvd Kansas City MO 64130-2807 Ph: (816) 923-5800 | Kidscare Leavenworth Pediatrics 1001 6th Ave Ste 210 Leavenworth KS 66048-3248 Ph: (816) 923-5800 |
| NPI Number | 1427749936 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 10/29/2024 |
| Medicare PECOS PAC ID | 5294644530 |
|---|---|
| Medicare Enrollment ID | O20231017000778 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427749936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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