1861421612 NPI number — CATHOLIC CHARITIES OF NORTHEAST KANSAS INC

Table of content: (NPI 1861421612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861421612 NPI number — CATHOLIC CHARITIES OF NORTHEAST KANSAS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATHOLIC CHARITIES OF NORTHEAST KANSAS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CATHOLIC COMMUNITY HOSPICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861421612
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9740 W 87TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66212-4563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-621-5090
Provider Business Mailing Address Fax Number:
913-371-3080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
234 S KANSAS AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66603-3617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-233-6300
Provider Business Practice Location Address Fax Number:
785-233-7234
Provider Enumeration Date:
07/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
EXECUTIVE DIRECTOR, HEALTHCARE
Authorized Official Telephone Number:
913-433-2012

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)