Healthcare Provider Details

I. General information

NPI: 1053372532
Provider Name (Legal Business Name): APPL ORCHARD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15417 PINEHURST DR
BASEHOR KS
66007-8237
US

IV. Provider business mailing address

15417 PINEHURST DR
BASEHOR KS
66007-8237
US

V. Phone/Fax

Practice location:
  • Phone: 913-724-7500
  • Fax: 913-724-7504
Mailing address:
  • Phone: 913-724-7500
  • Fax: 913-724-7504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA-105026-2
License Number StateKS

VIII. Authorized Official

Name: DR. BRADLEY ALAN APPL
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 913-724-7500