Provider Demographics
NPI:1962441378
Name:MIDLAND CARE CONNECTION, INC.
Entity Type:Organization
Organization Name:MIDLAND CARE CONNECTION, INC.
Other - Org Name:MIDLAND HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-232-2044
Mailing Address - Street 1:200 SW FRAZIER CIR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2800
Mailing Address - Country:US
Mailing Address - Phone:785-232-2044
Mailing Address - Fax:
Practice Address - Street 1:200 SW FRAZIER CIR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2800
Practice Address - Country:US
Practice Address - Phone:785-232-2044
Practice Address - Fax:785-232-5567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X, 251G00000X
KS251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100117670BMedicaid
KS241OtherBCBS PROVIDER NUMBER
KS100117670CMedicaid
KS241OtherBCBS PROVIDER NUMBER