Provider Demographics
NPI:1528169653
Name:VIACARE HOME HEALTH, LLC
Entity type:Organization
Organization Name:VIACARE HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:K
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-568-5220
Mailing Address - Street 1:332 NEOSHO ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-4160
Mailing Address - Country:US
Mailing Address - Phone:620-342-1700
Mailing Address - Fax:620-342-1725
Practice Address - Street 1:332 NEOSHO ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-4160
Practice Address - Country:US
Practice Address - Phone:620-342-1700
Practice Address - Fax:620-342-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA056009251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17-8049Medicare ID - Type UnspecifiedMEDICARE #