Organization
ASCENSION VIA CHRISTI HOME MEDICAL WICHITA, LLC
Active
Other names
Via Christi Home Medical Wichita, LLC, Ascension Via Christi Home Medical, Via Christi Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DEANA RAE HAYNES (SENIOR DIRECTOR)
(316) 858-2124
Entity
Organization
Contact information
Practice address
555 S WASHINGTON ST, SUITE 101, WICHITA, KS 67211-2424
(316) 265-4991
(316) 265-5204
Mailing address
PO BOX 1933, WICHITA, KS 67201-1933
(316) 265-4991
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100444310B
—
KS
01
—
48677
BCBS
KS
Enumeration date
06/20/2006
Last updated
06/18/2019
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