MEDICARE: HEART OF AMERICA HOSPICE KANSAS, L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376121046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART OF AMERICA HOSPICE KANSAS, L.L.C.

Provider Business Mailing Address
First Line	:	14295 MIDWAY RD STE 400
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-3678
Country	:	US
Telephone Number	:	903-537-8656
Fax Number	:	903-537-8420

Provider Business Practice Location Address
First Line	:	901 NE RIVER RD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66616-1142
Country	:	US
Telephone Number	:	785-228-0400
Fax Number	:	785-228-9049

Authorized Official
Title or Position	:	VP OF REGULATORY
Name	:	DEBRA MILLER
Credential	:
Telephone Number	:	903-537-7612

Provider Enumeration Date	:	04/01/2021
Last Update Date	:	04/01/2021

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