Healthcare Provider Details

I. General information

NPI: 1548625270
Provider Name (Legal Business Name): ASPEN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 T BONE DR
GARDEN CITY KS
67846-9019
US

IV. Provider business mailing address

1850 T BONE DR
GARDEN CITY KS
67846-9019
US

V. Phone/Fax

Practice location:
  • Phone: 620-272-6186
  • Fax: 620-275-0735
Mailing address:
  • Phone: 620-272-6186
  • Fax: 620-275-0735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROGER E BRADSHAW
Title or Position: PRESIDENT
Credential: RN
Phone: 620-272-8186