| NPI | 1063652519 |
|---|---|
| Other Name | PRIVATE SENIOR PROVIDERS ETP |
| Entity Type | Organization |
| Authorized Contact | NANCY SHERMAN Owner 816-394-1868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MO lco944539) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO lc0944539) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: MO lc0944539) | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2009-02-24 |