Provider Demographics
NPI:1407874449
Name:VIA CHRISTI HOME HEALTH PITTSBURG, LLC
Entity Type:Organization
Organization Name:VIA CHRISTI HOME HEALTH PITTSBURG, LLC
Other - Org Name:ASCENSION AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP, CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-309-5668
Mailing Address - Street 1:3 MED CENTER CIR STE B
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6677
Mailing Address - Country:US
Mailing Address - Phone:620-231-3088
Mailing Address - Fax:620-231-3130
Practice Address - Street 1:200 E CENTENNIAL DR STE 13
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6507
Practice Address - Country:US
Practice Address - Phone:620-231-3088
Practice Address - Fax:620-231-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-019-002251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201137030AMedicaid
177145Medicare PIN
KS00672OtherBCBS
KS177145Medicare Oscar/Certification