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General NPI Number Information
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NPI Number | 1649215047
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Entity Type | Organization
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Legal Business Name | ASCENSION VIA CHRISTI HOME MEDICAL WICHITA, LLC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 2601 CENTRAL AVE
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City | DODGE CITY
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State | KS
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Zip | 67801-6200
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Country | US
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Telephone | 620-227-7080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1933
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City | WICHITA
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State | KS
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Zip | 67201-1933
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Country | US
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Telephone | 620-227-7080
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Fax |
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Authorized Official
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Title or Position | SENIOR DIRECTOR
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Name | DEANA RAE HAYNES
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Credential |
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Telephone | 316-858-2124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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