Provider Demographics
NPI:1447495783
Name:MEDIQUIPONE
Entity type:Organization
Organization Name:MEDIQUIPONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHANHOLTZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-308-7292
Mailing Address - Street 1:320 NW CAPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-4723
Mailing Address - Country:US
Mailing Address - Phone:816-308-7292
Mailing Address - Fax:816-524-4313
Practice Address - Street 1:320 NW CAPITAL DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4723
Practice Address - Country:US
Practice Address - Phone:816-308-7292
Practice Address - Fax:816-524-4313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies