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NPI Code Detail

MEDICARE: CENTERWELL CERTIFIED HEALTHCARE CORP.

MEDICARE: CENTERWELL CERTIFIED HEALTHCARE CORP.
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
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1827390OTHERG2
2112135OTHERG2
319001OTHERG2
479298OTHERG2
5GA2202OTHERG2
6106825038OTHERG2
7113414024GOTHERG2
852655785OTHERG2
97803376OTHERG2
10MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
111016875OTHERG2
122886106OTHERG2
13146544OTHERG2
14510-07956OTHERG2
15ANC015OTHERG2

General Provider Information

NPI Number : 1891725693
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTERWELL CERTIFIED HEALTHCARE CORP.
Provider Business Mailing Address
First Line : 6330 SPRINT PKWY STE 300
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66211-1157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1303 HIGHTOWER TRL
Second Line : SUITE 105
City : ATLANTA
State : GA
Zip : 30350-2919
Country : US
Telephone Number : 770-998-1393
Fax Number :
Authorized Official
Title or Position : AUTHORIZED SIGNATORY
Name : JOHN NICHOLS
Credential :
Telephone Number : 770-998-1393
Provider Enumeration Date : 07/04/2006
Last Update Date : 02/15/2024

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Directions to “CENTERWELL CERTIFIED HEALTHCARE CORP. ” Practice Location

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