Provider Demographics
NPI:1639161359
Name:MERIDEN HOME CARE INC
Entity Type:Organization
Organization Name:MERIDEN HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-484-2699
Mailing Address - Street 1:7210 K4 HWY SUITE C
Mailing Address - Street 2:BOX 363
Mailing Address - City:MERIDEN
Mailing Address - State:KS
Mailing Address - Zip Code:66512-9499
Mailing Address - Country:US
Mailing Address - Phone:785-484-2699
Mailing Address - Fax:785-484-3347
Practice Address - Street 1:7210 K4 HWY SUITE C
Practice Address - Street 2:BOX 363
Practice Address - City:MERIDEN
Practice Address - State:KS
Practice Address - Zip Code:66512-9499
Practice Address - Country:US
Practice Address - Phone:785-484-2699
Practice Address - Fax:785-484-3347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA044003251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS178034Medicare ID - Type Unspecified