Provider Demographics
NPI:1548264229
Name:INTERIM HEALTH CARE OF WICHITA INC
Entity type:Organization
Organization Name:INTERIM HEALTH CARE OF WICHITA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:MORROW
Authorized Official - Last Name:STEHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-265-4295
Mailing Address - Street 1:9920 E HARRY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-5008
Mailing Address - Country:US
Mailing Address - Phone:316-265-4295
Mailing Address - Fax:316-265-4399
Practice Address - Street 1:9920 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5008
Practice Address - Country:US
Practice Address - Phone:316-265-4295
Practice Address - Fax:316-265-4399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-087-003251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS3000392101Medicaid