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General NPI Number Information
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NPI Number | 1245278605
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Entity Type | Organization
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Legal Business Name | THI OF KANSAS AT WICHITA SPECIALTY, LLC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 8080 E PAWNEE ST
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City | WICHITA
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State | KS
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Zip | 67207-5475
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Country | US
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Telephone | 316-682-0004
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Fax |
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Provider Business Mailing Address
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Address Line | 930 RIDGEBROOK RD
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City | SPARKS
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State | MD
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Zip | 21152-9390
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Country | US
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Telephone | 410-773-1000
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Fax | 410-773-1321
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRYAN ROBY
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Credential |
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Telephone | 316-682-0004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | H087007
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License Number State | KS
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