Provider Demographics
NPI:1467473140
Name:BLESSED TRINTIY HOME HEALTH
Entity Type:Organization
Organization Name:BLESSED TRINTIY HOME HEALTH
Other - Org Name:CARTER HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-947-7700
Mailing Address - Street 1:3105 S MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73119-1022
Mailing Address - Country:US
Mailing Address - Phone:405-947-7700
Mailing Address - Fax:405-947-7300
Practice Address - Street 1:6376 COLLEGE BLVD STE B
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1506
Practice Address - Country:US
Practice Address - Phone:913-901-0440
Practice Address - Fax:888-865-2903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200266190BMedicaid