| Organization Name: | NORTHEAST KANSAS CENTER FOR HEALTH AND WELLNESS, INC. |
| NPI Number: | 1912934951 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DALE A WHITE (CEO) |
| Mailing Address: | 100 W 8th St Horton |
| State: | KS US |
| Postal Code: | 664391602 |
| Phone Number: | 7854862848 |
| Fax Number: | 7854862842 |
| NPI Enumeration Date: | 06/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 5-01550 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |