Provider Demographics
NPI:1144641895
Name:MIDWEST HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:MIDWEST HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRENTON
Authorized Official - Middle Name:JEREL
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-655-7441
Mailing Address - Street 1:3540 N INWOOD ST
Mailing Address - Street 2:APARTMENT 9301
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-7801
Mailing Address - Country:US
Mailing Address - Phone:316-655-7441
Mailing Address - Fax:
Practice Address - Street 1:1624 S RUTAN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3918
Practice Address - Country:US
Practice Address - Phone:316-361-6240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-25
Last Update Date:2013-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA087174251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health