Provider Demographics
NPI:1588602213
Name:OLATHE MEDICAL CENTER INC
Entity Type:Organization
Organization Name:OLATHE MEDICAL CENTER INC
Other - Org Name:OLATHE HEALTH HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/QUALITY & CHIEF COMPLIANCE OFFCR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WIENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-791-4459
Mailing Address - Street 1:20333 W 151ST ST
Mailing Address - Street 2:OLATHE HEALTH HOME HEALTHCARE
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5350
Mailing Address - Country:US
Mailing Address - Phone:913-791-4459
Mailing Address - Fax:913-791-4458
Practice Address - Street 1:20920 W 151ST ST
Practice Address - Street 2:SUITE 204
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7247
Practice Address - Country:US
Practice Address - Phone:913-324-8515
Practice Address - Fax:913-324-8517
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OLATHE MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-03
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA046041251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100099250BMedicaid
177193Medicare Oscar/Certification