Provider Demographics
NPI:1902822208
Name:SUNFLOWER HOME HEALTH STORE, INC.
Entity Type:Organization
Organization Name:SUNFLOWER HOME HEALTH STORE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNEW
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-275-4440
Mailing Address - Street 1:2915 E MARY ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-9275
Mailing Address - Country:US
Mailing Address - Phone:620-272-9797
Mailing Address - Fax:620-272-9798
Practice Address - Street 1:2915 E MARY ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-9275
Practice Address - Country:US
Practice Address - Phone:620-272-9797
Practice Address - Fax:620-272-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS118429OtherBLUE CROSS BLUE SHIELD
KS200401080AMedicaid
KS5752330001Medicare PIN
KS118429OtherBLUE CROSS BLUE SHIELD