Basic Information
| Provider Information | |||||||||
| NPI: | 1558806489 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CATALYS HEALTH LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 902 N 5TH ST | ||||||||
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| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678465640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8487706051 | ||||||||
| FaxNumber: | 8475139947 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 E SPRUCE ST | ||||||||
| Address2: | SUITE 2B | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678465614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6207654324 | ||||||||
| FaxNumber: | 6204644732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2017 | ||||||||
| LastUpdateDate: | 01/02/2017 | ||||||||
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| AuthorizedOfficialLastName: | BIRKY | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6207654324 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.