1467473140 NPI number — BLESSED TRINTIY HOME HEALTH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467473140 NPI number — BLESSED TRINTIY HOME HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLESSED TRINTIY HOME HEALTH
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:
CARTER HEALTHCARE
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:
1467473140
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3105 S MERIDIAN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73119-1022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-947-7700
Provider Business Mailing Address Fax Number:
405-947-7300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6376 COLLEGE BLVD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66211-1506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-901-0440
Provider Business Practice Location Address Fax Number:
888-865-2903
Provider Enumeration Date:
07/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PETERS
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
BILLING SUPERVISOR
Authorized Official Telephone Number:
405-947-7700

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200266190B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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