MEDICARE: LAB CAB OF WICHITA, 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	251F00000X	Home Infusion Agency

General Provider Information

NPI Number	:	1467265967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAB CAB OF WICHITA, LLC

Provider Business Mailing Address
First Line	:	PO BOX 83
Second Line	:
City	:	GARDEN PLAIN
State	:	KS
Zip	:	67050-0083
Country	:	US
Telephone Number	:	316-223-0572
Fax Number	:

Provider Business Practice Location Address
First Line	:	30912 W 23RD ST S
Second Line	:
City	:	GARDEN PLAIN
State	:	KS
Zip	:	67050-9050
Country	:	US
Telephone Number	:	316-223-0572
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	THERESA A REGIER
Credential	:
Telephone Number	:	316-223-0572

Provider Enumeration Date	:	01/29/2025
Last Update Date	:	01/29/2025

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Directions to “LAB CAB OF WICHITA, LLC ” Practice Location

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