# AZD DERBY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174120539
- **Authorized official:** NOAH KAMINER (MANAGER)
- **Authorized official phone:** (316) 788-3739

## Contact information

- **Practice address:** 445 N WESTVIEW DR, DERBY, KS 67037-2228
- **Practice address phone:** (316) 788-3739
- **Mailing address:** 702 S HIGHWAY 6, GRETNA, NE 68028-7970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/07/2020
- **Last updated:** 10/07/2020