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1306 State St Augusta KS 67010-1126 | |
| (316) 775-9191 | |
| (316) 775-0348 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1306 State St, Augusta, Kansas |
| Authorized Official Name and Position | Lynette Scheid (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 3162016711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1306 State St Augusta KS 67010-1126 Ph: (316) 775-9191 | 1306 State St Augusta KS 67010-1126 Ph: (316) 775-9191 |
| NPI Number | 1508060864 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 10/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508060864 | NPI | - | NPPES |
| 100359330B | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 17D0970229 (Kansas) | Primary |
Authentic Living Counseling Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7939 Sw 163rd St, Augusta, KS 67010 Phone: 360-899-8577 | |