Provider Demographics
NPI:1568160455
Name:WARDEN UNLIMITED LLC
Entity Type:Organization
Organization Name:WARDEN UNLIMITED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:R
Authorized Official - Last Name:WARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:316-708-0219
Mailing Address - Street 1:2146 N COLLECTIVE LN STE 110
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3574
Mailing Address - Country:US
Mailing Address - Phone:316-260-4100
Mailing Address - Fax:316-260-5178
Practice Address - Street 1:2146 N COLLECTIVE LN STE 110
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3574
Practice Address - Country:US
Practice Address - Phone:316-260-4100
Practice Address - Fax:316-260-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center