Provider Demographics
NPI:1285026351
Name:HOUSE CALL MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:HOUSE CALL MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER/BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:
Authorized Official - Last Name:BACON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-722-2138
Mailing Address - Street 1:5721 N ATHENIAN AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-1844
Mailing Address - Country:US
Mailing Address - Phone:316-722-2138
Mailing Address - Fax:800-764-6095
Practice Address - Street 1:7701 E KELLOGG DR
Practice Address - Street 2:SUITE 490
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-1706
Practice Address - Country:US
Practice Address - Phone:316-722-2138
Practice Address - Fax:800-764-6095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46278363LF0000X
KS76470363LF0000X
KS80145363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty