Provider Demographics
NPI:1609222686
Name:HOSPICE SERVICES OF NORTHWEST KANSAS, INC
Entity Type:Organization
Organization Name:HOSPICE SERVICES OF NORTHWEST KANSAS, INC
Other - Org Name:PALLIATIVE CARE OF NORTHWEST KANSAS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-543-2900
Mailing Address - Street 1:424 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-2513
Mailing Address - Country:US
Mailing Address - Phone:785-543-2900
Mailing Address - Fax:785-543-5688
Practice Address - Street 1:424 8TH ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-2513
Practice Address - Country:US
Practice Address - Phone:785-543-2900
Practice Address - Fax:785-543-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100221170BMedicaid
KS100221170BMedicaid