Provider Demographics
NPI: | 1912181975 |
---|---|
Name: | DEBBIE BURNETT |
Entity Type: | Organization |
Organization Name: | DEBBIE BURNETT |
Other - Org Name: | ALL ABOUT YOU |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | DEBBIE |
Authorized Official - Middle Name: | LYNN |
Authorized Official - Last Name: | BURNETT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 620-431-7743 |
Mailing Address - Street 1: | 1110 W MAIN ST |
Mailing Address - Street 2: | |
Mailing Address - City: | CHANUTE |
Mailing Address - State: | KS |
Mailing Address - Zip Code: | 66720-1412 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 620-431-7743 |
Mailing Address - Fax: | 620-431-7745 |
Practice Address - Street 1: | 1110 W MAIN ST |
Practice Address - Street 2: | |
Practice Address - City: | CHANUTE |
Practice Address - State: | KS |
Practice Address - Zip Code: | 66720-1412 |
Practice Address - Country: | US |
Practice Address - Phone: | 620-431-7743 |
Practice Address - Fax: | 620-431-7745 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-12-26 |
Last Update Date: | 2008-06-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KS | 5435670001 | Medicare NSC |