Provider Demographics
NPI:1063704401
Name:PULMONARY AND SLEEP CONSULTANTS OF KANSAS, LLC
Entity type:Organization
Organization Name:PULMONARY AND SLEEP CONSULTANTS OF KANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-440-1010
Mailing Address - Street 1:3009 N. CYPRESS
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4003
Mailing Address - Country:US
Mailing Address - Phone:316-440-1010
Mailing Address - Fax:316-440-0802
Practice Address - Street 1:3009 N. CYPRESS
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4003
Practice Address - Country:US
Practice Address - Phone:316-440-1010
Practice Address - Fax:316-440-0802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS207RC0200X, 207RS0012X, 207RP1001X
207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200328110AOtherMEDICAID
KS200717670AMedicaid
KSKA2253Medicare PIN