Provider Demographics
NPI:1992708598
Name:HEARTLAND SURGICAL SPECIALTY HOSPITAL, LLC
Entity type:Organization
Organization Name:HEARTLAND SURGICAL SPECIALTY HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-387-0874
Mailing Address - Street 1:4901 COLLEGE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1602
Mailing Address - Country:US
Mailing Address - Phone:913-754-5000
Mailing Address - Fax:913-754-4560
Practice Address - Street 1:4901 COLLEGE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1602
Practice Address - Country:US
Practice Address - Phone:913-754-5000
Practice Address - Fax:913-754-4560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH046013282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200306450AMedicaid
MO016172702Medicaid
KSH046013OtherSTATE
KSH046013OtherSTATE
KS200306450AMedicaid