Provider Demographics
NPI:1104397124
Name:BRIDGES HEALTHCARE INC
Entity Type:Organization
Organization Name:BRIDGES HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:316-260-4409
Mailing Address - Street 1:313 S. MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202
Mailing Address - Country:US
Mailing Address - Phone:316-265-9441
Mailing Address - Fax:316-265-8657
Practice Address - Street 1:313 S. MARKET STREET
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202
Practice Address - Country:US
Practice Address - Phone:316-265-9441
Practice Address - Fax:316-265-8657
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRY HYNES MEMORIAL HOSPICE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-17
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201244330AMedicaid