Healthcare Provider Details

I. General information

NPI: 1629715446
Provider Name (Legal Business Name): BRIDGES HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S MARKET ST
WICHITA KS
67202-3805
US

IV. Provider business mailing address

313 S MARKET ST
WICHITA KS
67202-3805
US

V. Phone/Fax

Practice location:
  • Phone: 316-219-1735
  • Fax:
Mailing address:
  • Phone: 316-219-1735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA Z SNYDER
Title or Position: ADMINISTRATOR
Credential: RPH
Phone: 316-260-4409