Organization
ASCENSION VIA CHRISTI HOME MEDICAL WICHITA, LLC
Active
Parent organization
ASCENSION VIA CHRISTI HOME MEDICAL WICHITA, LLC
Other names
Via Christi Home Medical Wichita, LLC, Via Christi Home Medical, Ascension Via Christi Home Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASCENSION VIA CHRISTI HOME MEDICAL WICHITA, LLC
Authorized official
DEANA RAE HAYNES (SENIOR DIRECTOR)
(316) 858-2124
Entity
Organization
Contact information
Practice address
322 N MAIN ST, GARDEN CITY, KS 67846-5426
(620) 275-0863
Mailing address
PO BOX 1933, WICHITA, KS 67201-1933
(620) 275-0863
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
—
100444300A
—
KS
01
—
48488
BLUE CROSS/BLUE SHIELD
KS
Enumeration date
06/22/2006
Last updated
06/18/2019
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