Provider Demographics
NPI:1316013469
Name:EECP HEART CENTER OF KANSAS INC
Entity Type:Organization
Organization Name:EECP HEART CENTER OF KANSAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-269-5000
Mailing Address - Street 1:551 N HILLSIDE ST STE 130
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4924
Mailing Address - Country:US
Mailing Address - Phone:316-858-1188
Mailing Address - Fax:316-858-1190
Practice Address - Street 1:551 N HILLSIDE ST STE 130
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4924
Practice Address - Country:US
Practice Address - Phone:316-858-1188
Practice Address - Fax:316-858-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0413261207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty