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General NPI Number Information
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NPI Number | 1740361534
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Entity Type | Organization
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Legal Business Name | MEDICALODGES. INC.
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 410 JUNIPER DR
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City | HOLTON
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State | KS
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Zip | 66436-1535
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Country | US
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Telephone | 785-364-5051
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Fax | 785-364-5010
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Provider Business Mailing Address
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Address Line | 410 JUNIPER DR
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City | HOLTON
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State | KS
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Zip | 66436-1535
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Country | US
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Telephone | 785-364-5051
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Fax | 785-364-5010
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. CATHY W FISHER
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Credential |
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Telephone | 620-251-6700
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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 | N043004
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | N043004
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | N043004
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License Number State | KS
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