MEDICARE: THE UNIVERSITY OF KANSAS HEALTH SYSTEM HOSPICE - GREAT BEND, LLC

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1376330456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE UNIVERSITY OF KANSAS HEALTH SYSTEM HOSPICE - GREAT BEND, LLC

Provider Business Mailing Address
First Line	:	3421 FOREST AVE
Second Line	:
City	:	GREAT BEND
State	:	KS
Zip	:	67530-3605
Country	:	US
Telephone Number	:	620-792-8171
Fax Number	:

Provider Business Practice Location Address
First Line	:	3421 FOREST AVE
Second Line	:
City	:	GREAT BEND
State	:	KS
Zip	:	67530-3605
Country	:	US
Telephone Number	:	620-792-8171
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & VICE CHAIR
Name	:	DR. BRADLEY A APPL
Credential	:
Telephone Number	:	620-792-8171

Provider Enumeration Date	:	04/22/2025
Last Update Date	:	06/30/2025

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