Provider Demographics
NPI:1982850616
Name:PATHWAYS PAYROLL SERVICES, LLC
Entity type:Organization
Organization Name:PATHWAYS PAYROLL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-364-5668
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66839-0063
Mailing Address - Country:US
Mailing Address - Phone:620-364-5668
Mailing Address - Fax:620-364-5622
Practice Address - Street 1:1208 LYNX RD SW
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KS
Practice Address - Zip Code:66839-9249
Practice Address - Country:US
Practice Address - Phone:620-364-5668
Practice Address - Fax:620-364-5622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200302810AMedicaid