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General NPI Number Information
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NPI Number | 1316177959
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Entity Type | Organization
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Legal Business Name | DERBY HEALTH & REHABILITATION
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 731 KLEIN CIR
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City | DERBY
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State | KS
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Zip | 67037-7011
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Country | US
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Telephone | 316-773-1313
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Fax | 316-295-4379
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Provider Business Mailing Address
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Address Line | 7200 W 13TH ST N STE 10
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City | WICHITA
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State | KS
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Zip | 67212-2968
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Country | US
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Telephone | 316-773-1313
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Fax | 316-295-4379
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Authorized Official
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Title or Position | CEO
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Name | FRED HERMES
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Credential |
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Telephone | 316-773-1313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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