MEDICARE: CENTERWELL CERTIFIED HEALTHCARE CORP.

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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	3722	OTHER	G2
2	7349528	OTHER	G2
3	1020847	OTHER	G2
4	013100P	OTHER	G2
5	07959	OTHER	G2
6	115712	OTHER	G2
7	51526313	OTHER	G2
8	510-07956	OTHER	G2
9	6000048	OTHER	G2
10	79298	OTHER	G2
11	ANC015	OTHER	G2
12	51041146	OTHER	G2
13	017151	OTHER	G2
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	2352450	OTHER	G2
16	4546469	OTHER	G2
17	510-50592	OTHER	G2

General Provider Information

NPI Number	:	1841229754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERWELL CERTIFIED HEALTHCARE CORP.

Provider Business Mailing Address
First Line	:	6330 SPRINT PKWY STE 300
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66211-1157
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	88 ALI WAY STE 84
Second Line	:
City	:	OXFORD
State	:	AL
Zip	:	36203-1835
Country	:	US
Telephone Number	:	256-835-7101
Fax Number	:	256-835-7190

Authorized Official
Title or Position	:	AUTHORIZED SIGNATORY
Name	:	JOHN NICHOLS
Credential	:
Telephone Number	:	256-835-7101

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	05/16/2024

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Directions to “CENTERWELL CERTIFIED HEALTHCARE CORP. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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