Provider Demographics
NPI:1639423981
Name:GODSPEED, INC.
Entity Type:Organization
Organization Name:GODSPEED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:SWEARINGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-425-7717
Mailing Address - Street 1:505 S BROADWAY ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3900
Mailing Address - Country:US
Mailing Address - Phone:316-425-7717
Mailing Address - Fax:316-260-3317
Practice Address - Street 1:505 S BROADWAY ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-3900
Practice Address - Country:US
Practice Address - Phone:316-425-7717
Practice Address - Fax:316-260-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA087134251E00000X, 251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion