Provider Demographics
NPI:1386906519
Name:COMMUNITY CARE HEALTH PLAN OF KANSAS, INC.
Entity type:Organization
Organization Name:COMMUNITY CARE HEALTH PLAN OF KANSAS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT MIDWEST MEDICARE
Authorized Official - Prefix:
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HINDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-387-8275
Mailing Address - Street 1:1010 SW TYLER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66612-1720
Mailing Address - Country:US
Mailing Address - Phone:800-331-1476
Mailing Address - Fax:
Practice Address - Street 1:1010 SW TYLER ST FL 2
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66612-1720
Practice Address - Country:US
Practice Address - Phone:800-331-1476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTHEM PARTNERSHIP HOLDING COMPANY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-13
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS302R00000X
302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization