Provider Demographics
NPI:1306244306
Name:BROADWAY HOME MEDICAL INC
Entity type:Organization
Organization Name:BROADWAY HOME MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-264-8600
Mailing Address - Street 1:808 S HILLSIDE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-3004
Mailing Address - Country:US
Mailing Address - Phone:316-264-8600
Mailing Address - Fax:316-264-1999
Practice Address - Street 1:3729 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4925
Practice Address - Country:US
Practice Address - Phone:316-719-2223
Practice Address - Fax:316-719-2255
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROADWAY HOME MEDICAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies