Organization
NATIONWIDE HEALTH SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY R MATTOX RN (ADMINISTRATOR)
(913) 631-3844
Entity
Organization
Contact information
Practice address
6538 HALLET ST, SHAWNEE, KS 66216-2209
(913) 631-0538
Mailing address
11111 W 59TH TER, STE 103, SHAWNEE, KS 66203-2713
(913) 631-3844
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
A046146
KS
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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