MEDICARE: CARDIOCARE HOME HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1490331041	KS

General Provider Information

NPI Number	:	1295991214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOCARE HOME HEALTH

Provider Business Mailing Address
First Line	:	235 N BURNS AVE
Second Line	:
City	:	VALLEY CENTER
State	:	KS
Zip	:	67147-2326
Country	:	US
Telephone Number	:	316-558-1999
Fax Number	:	817-886-8715

Provider Business Practice Location Address
First Line	:	235 N BURNS AVE
Second Line	:
City	:	VALLEY CENTER
State	:	KS
Zip	:	67147-2326
Country	:	US
Telephone Number	:	316-558-1999
Fax Number	:	817-886-8715

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TYSON E YARNELL
Credential	:	RN, COS-C
Telephone Number	:	316-558-1999

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	07/29/2008

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Directions to “CARDIOCARE HOME HEALTH ” Practice Location

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