Organization
VIA CHRISTI HOME MEDICAL WICHITA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANA RAE HAYNES (SENIOR DIRECTOR)
(316) 858-2124
Entity
Organization
Contact information
Practice address
14700 W. ST. TERESA, SUITE 100, WICHITA, KS 67235-9603
(316) 796-7880
(316) 796-7884
Mailing address
PO BOX 1933, WICHITA, KS 67201-1933
(316) 796-7880
(316) 796-7884
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100444280D
—
KS
01
—
347591
BCBS
KS
Enumeration date
09/22/2010
Last updated
10/27/2017
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