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General NPI Number Information
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NPI Number | 1295991214
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Entity Type | Organization
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Legal Business Name | CARDIOCARE HOME HEALTH
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 235 N BURNS AVE
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City | VALLEY CENTER
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State | KS
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Zip | 67147-2326
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Country | US
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Telephone | 316-558-1999
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Fax | 817-886-8715
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Provider Business Mailing Address
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Address Line | 235 N BURNS AVE
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City | VALLEY CENTER
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State | KS
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Zip | 67147-2326
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Country | US
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Telephone | 316-558-1999
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Fax | 817-886-8715
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Authorized Official
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Title or Position | PRESIDENT
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Name | TYSON E YARNELL
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Credential | RN, COS-C
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Telephone | 316-558-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1490331041
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License Number State | KS
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