Organization
MEDICALODGES, INC.
Active
Organization
MEDICALODGES, INC.
Active
Other names
Gran Villas Hiawatha
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 KANSAS AVE, HIAWATHA, KS 66434-1954
(785) 742-4566
(785) 742-4573
Mailing address
400 KANSAS AVE, HIAWATHA, KS 66434-1954
(785) 742-4566
(785) 742-4573
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
N007006
KS
261QA0600X
Adult Day Care Clinic/Center
Primary
N007006
KS
332BC3200X
Customized Equipment (DME)
N007006
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100026530P
—
KS
Enumeration date
10/18/2006
Last updated
06/23/2008
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