Provider Demographics
NPI:1619970878
Name:SANDPIPER BAY HEALTH AND RETIERMENT CENTER, INC
Entity Type:Organization
Organization Name:SANDPIPER BAY HEALTH AND RETIERMENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-945-3606
Mailing Address - Street 1:5808 W 8TH
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212
Mailing Address - Country:US
Mailing Address - Phone:316-945-3606
Mailing Address - Fax:316-945-9296
Practice Address - Street 1:5808 W 8TH
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212
Practice Address - Country:US
Practice Address - Phone:316-945-3606
Practice Address - Fax:316-945-9296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN087029251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS175344Medicare ID - Type UnspecifiedMEDICARE