Organization
GERIATRIC HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA K GRINDSTAFF (ADMINISTRATOR)
(816) 276-6450
Entity
Organization
Contact information
Practice address
8301 STATE LINE RD, SUITE 100, KANSAS CITY, MO 64114-2025
(816) 276-6450
(816) 276-6455
Mailing address
8301 STATE LINE RD, SUITE 100, KANSAS CITY, MO 64114-2025
(816) 276-6450
(816) 276-6455
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200568640A
—
KS
05
—
508554607
—
MO
01
—
DN6685
RAILROAD MEDICARE PIN
KS
01
—
DN6706
RAILROAD MEDICARE PIN
MO
Enumeration date
01/09/2008
Last updated
11/17/2008
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