MEDICARE: SUNFLOWER HOME HEALTH STORE, INC.

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	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	118429	OTHER	KS	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902822208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNFLOWER HOME HEALTH STORE, INC.

Provider Business Mailing Address
First Line	:	2915 E MARY ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-9275
Country	:	US
Telephone Number	:	620-272-9797
Fax Number	:	620-272-9798

Provider Business Practice Location Address
First Line	:	2915 E MARY ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-9275
Country	:	US
Telephone Number	:	620-272-9797
Fax Number	:	620-272-9798

Authorized Official
Title or Position	:	OWNEW
Name	:	MS. CHRISTA LEIGH MCKINNEY
Credential	:	R.N.
Telephone Number	:	620-275-4440

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/26/2008

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Directions to “SUNFLOWER HOME HEALTH STORE, INC. ” Practice Location

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