Organization
BATHCREST OF WICHITA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA JEAN NICHOLAS (VICE PRESIDENT)
(316) 685-1627
Entity
Organization
Contact information
Practice address
11426 E PAWNEE ST, WICHITA, KS 67207-6406
(316) 685-1627
(316) 685-6061
Mailing address
11426 E PAWNEE ST, WICHITA, KS 67207-6406
(316) 685-1627
(316) 685-6061
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200574070A
HCBS
KS
Enumeration date
11/11/2008
Last updated
11/11/2008
Update your record
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