Healthcare Provider Details

I. General information

NPI: 1982472007
Provider Name (Legal Business Name): STORMONT VAIL HEALTH FLINT HILLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 SAINT MARYS RD
JUNCTION CITY KS
66441-4139
US

IV. Provider business mailing address

1102 SAINT MARYS RD
JUNCTION CITY KS
66441-4139
US

V. Phone/Fax

Practice location:
  • Phone: 785-238-0325
  • Fax:
Mailing address:
  • Phone: 785-238-0325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TODD ANTHONY LUTZ
Title or Position: DIRECTOR
Credential:
Phone: 785-354-5215