Organization
PHS KS MOIRAI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BAKER (CEO)
(918) 664-9729
Entity
Organization
Contact information
Practice address
1510 WALNUT ST, COFFEYVILLE, KS 67337-6641
(800) 771-9729
Mailing address
8181 E 46TH ST, TULSA, OK 74145-4801
(918) 664-9729
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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