Provider Demographics
NPI:1710002472
Name:TENDER CARE PEDIATRICS PA
Entity Type:Organization
Organization Name:TENDER CARE PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:I
Authorized Official - Last Name:SCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-322-7723
Mailing Address - Street 1:700 W. CENTRAL AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042
Mailing Address - Country:US
Mailing Address - Phone:316-322-7723
Mailing Address - Fax:376-321-3883
Practice Address - Street 1:700 W. CENTRAL AVE
Practice Address - Street 2:STE 210
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042
Practice Address - Country:US
Practice Address - Phone:316-322-7723
Practice Address - Fax:376-321-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-28931208000000X
KS04-30497208000000X
208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS461025OtherFAMILY HEALTH PARTNERS
KS111026Medicare ID - Type Unspecified