Basic Information
Provider Information
NPI: 1396045423
EntityType: 2
ReplacementNPI:  
OrganizationName: SWOPE HEALTH SERVICES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: SWOPE HEALTH SOUTH
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3801 BLUE PARKWAY
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641302807
CountryCode: US
TelephoneNumber: 8169235800
FaxNumber:  
Practice Location
Address1: 8825 TROOST
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641314731
CountryCode: US
TelephoneNumber: 8169221000
FaxNumber: 8169221078
Other Information
ProviderEnumerationDate: 10/22/2010
LastUpdateDate: 05/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: PATEL
AuthorizedOfficialFirstName: NAIMISH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO/COO
AuthorizedOfficialTelephone: 8165995552
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400X  Y Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

No ID Information.


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