Healthcare Provider Details

I. General information

NPI: 1386906519
Provider Name (Legal Business Name): COMMUNITY CARE HEALTH PLAN OF KANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 SW TYLER ST FL 2
TOPEKA KS
66612-1720
US

IV. Provider business mailing address

1010 SW TYLER ST FL 2
TOPEKA KS
66612-1720
US

V. Phone/Fax

Practice location:
  • Phone: 800-331-1476
  • Fax:
Mailing address:
  • Phone: 800-331-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateKS

VIII. Authorized Official

Name: MELISA HINDERS
Title or Position: PRESIDENT MIDWEST MEDICARE
Credential:
Phone: 404-387-8275