Organization
COLLEGIATE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN PETERSON (PRESIDENT)
(913) 269-0330
Entity
Organization
Contact information
Practice address
6721 W 128TH PL, 104, OVERLAND PARK, KS 66209-3842
(913) 269-0330
(913) 273-1070
Mailing address
PO BOX 9238, SHAWNEE MISSION, KS 66201-1838
(913) 269-0330
(913) 273-1070
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/13/2013
Last updated
05/13/2013
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