Healthcare Provider Details

I. General information

NPI: 1669122966
Provider Name (Legal Business Name): HOME TOWN HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 WASHINGTON ST STE B
LYNDON KS
66451-9870
US

IV. Provider business mailing address

PO BOX 481
LYNDON KS
66451-0481
US

V. Phone/Fax

Practice location:
  • Phone: 785-310-0001
  • Fax: 785-828-3318
Mailing address:
  • Phone: 785-310-0001
  • Fax: 785-828-3318

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: MRS. DEBRA R SHINKLE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 620-378-3760