Provider Demographics
NPI:1669476909
Name:ATCHISON HOME HEALTH EQUIPMENT, INC
Entity type:Organization
Organization Name:ATCHISON HOME HEALTH EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HART JR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-367-4099
Mailing Address - Street 1:708 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-2435
Mailing Address - Country:US
Mailing Address - Phone:913-367-4099
Mailing Address - Fax:913-367-2040
Practice Address - Street 1:708 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-2435
Practice Address - Country:US
Practice Address - Phone:913-367-4099
Practice Address - Fax:913-367-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS012920OtherBC/BS KANSAS PROVIDER NUM
KS100441890AMedicaid
KS012920OtherBC/BS KANSAS PROVIDER NUM