Provider Demographics
NPI:1295991214
Name:CARDIOCARE HOME HEALTH
Entity type:Organization
Organization Name:CARDIOCARE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:E
Authorized Official - Last Name:YARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, COS-C
Authorized Official - Phone:316-558-1999
Mailing Address - Street 1:235 N BURNS AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67147-2326
Mailing Address - Country:US
Mailing Address - Phone:316-558-1999
Mailing Address - Fax:817-886-8715
Practice Address - Street 1:235 N BURNS AVE
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67147-2326
Practice Address - Country:US
Practice Address - Phone:316-558-1999
Practice Address - Fax:817-886-8715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1490331041251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health