Provider Demographics
NPI:1487638508
Name:HARRY HYNES MEMORIAL HOSPICE, INC.
Entity Type:Organization
Organization Name:HARRY HYNES MEMORIAL HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-265-9441
Mailing Address - Street 1:313 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3805
Mailing Address - Country:US
Mailing Address - Phone:316-265-9441
Mailing Address - Fax:316-265-6066
Practice Address - Street 1:313 S MARKET ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-3805
Practice Address - Country:US
Practice Address - Phone:316-265-9441
Practice Address - Fax:316-265-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000831OtherBLUE CROSS BLUE SHIELD
KS100221070BMedicaid
KS4801OtherBLUE CROSS BLUE SHIELD
KS04803OtherBLUE CROSS BLUE SHIELD
KS000831OtherBLUE CROSS BLUE SHIELD