Provider Demographics
NPI:1720118110
Name:PROMOHISPANO INC.
Entity type:Organization
Organization Name:PROMOHISPANO INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:913-371-3334
Mailing Address - Street 1:825 N 7TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66101
Mailing Address - Country:US
Mailing Address - Phone:913-371-3334
Mailing Address - Fax:913-371-2760
Practice Address - Street 1:825 N 7TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101
Practice Address - Country:US
Practice Address - Phone:913-371-3334
Practice Address - Fax:913-371-2760
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMOHISPANO INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-06
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO05544156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2004216704Medicaid