Basic Information
| Provider Information | |||||||||
| NPI: | 1790982825 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VETRANS MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1830 S TARA FALLS CT | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672076569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162603210 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5500 E KELLOGG DR | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672181607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166852221 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SPIERS | ||||||||
| AuthorizedOfficialFirstName: | NICOLE | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | RESPIRATORY THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 3162603210 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | CRT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 286500000X | 1603295 | KS | Y | Hospitals | Military Hospital |
No ID Information.