Organization
MEDICALODGES, INC.
Active
Other names
Gran Villas Neodesha
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY W FISHER (CHIEF FINANCIAL OFFICER)
(620) 251-6700
Entity
Organization
Contact information
Practice address
400 FIR ST, NEODESHA, KS 66757-1298
(620) 325-2244
(620) 325-2762
Mailing address
400 FIR ST, NEODESHA, KS 66757-1298
(620) 325-2244
(620) 325-2762
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
N103005
KS
261QA0600X
Adult Day Care Clinic/Center
Primary
N103005
KS
332B00000X
Durable Medical Equipment & Medical Supplies
N103005
KS
332BC3200X
Customized Equipment (DME)
N103005
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100026530V
—
KS
05
—
100068170D
—
KS
Enumeration date
10/18/2006
Last updated
06/23/2008
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