Medicalodges, Inc.
Organization Active NPI Adult Day Care Clinic/Center · Fredonia, KS
NPI 1407937352 · NPPES record last updated Jun 23, 2008
Key facts
- NPI
- 1407937352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Day Care Clinic/Center 261QA0600X
- License
- N103004 (KS)
- Legal business name
- MEDICALODGES, INC.
- Practice address
- 2111 E Washington St
Fredonia, KS 66736-1757 - Phone
- (620) 378-2329
- Fax
- (620) 378-2792
- NPI assigned
- Oct 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Cathy W Fisher
- Title
- Chief Financial Officer
- Phone
- (620) 251-6700
Corporate family (same tax ID) 46
National Provider Directory
- Tax ID family
- Medicalodges Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | N103004 | KS | |
| Adult Day Care Clinic/Center | 261QA0600X | N103004 | KS | Yes |
| Durable Medical Equipment & Medical Supplies | 332B00000X | N103004 | KS | |
| Customized Equipment (DME) | 332BC3200X | N103004 | KS |
Addresses
Primary practice location
2111 E Washington St
Fredonia, KS 66736-1757
Mailing address
2111 E Washington St
Fredonia, KS 66736-1757
Phone (620) 378-2329
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100026530W | Medicaid | KS | |
| 100068170C | Medicaid | KS |
Other names
- Gran Villas Kansas City
Other providers in Fredonia, KS
- Home Town Health Care, LLC
- Jennifer Bacani McKenney, MD, LLC
- Jenessa D Kleopfer
- Terry Lea Marr
- Jennifer Bacani McKenney
- Morningstar Care Homes, LLC
- Terry L Morris
- Megan Glyn Noland
- Kelly Odell
- One Health Solutions LLC
All providers in Fredonia, KS · Adult Day Care Clinic/Center in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.