Healthcare Provider Details

I. General information

NPI: 1487638508
Provider Name (Legal Business Name): HARRY HYNES MEMORIAL HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 11/08/2016
Certification Date:
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: 316-265-9441
  • Fax: 316-265-6066
Mailing address:
  • Phone: 316-265-9441
  • Fax: 316-265-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateKS

VIII. Authorized Official

Name: MRS. RENEE HAHN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 316-265-9441