Healthcare Provider Details

I. General information

NPI: 1316177959
Provider Name (Legal Business Name): DERBY HEALTH & REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 KLEIN CIR
DERBY KS
67037-7011
US

IV. Provider business mailing address

7200 W 13TH ST N STE 10
WICHITA KS
67212-2968
US

V. Phone/Fax

Practice location:
  • Phone: 316-773-1313
  • Fax: 316-295-4379
Mailing address:
  • Phone: 316-773-1313
  • Fax: 316-295-4379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: FRED HERMES
Title or Position: CEO
Credential:
Phone: 316-773-1313