Centralia Medical Clinic | |
606 1st St Centralia KS 66415-9637 | |
(785) 857-3334 | |
(785) 857-3349 |
Full Name | Centralia Medical Clinic |
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Speciality | Clinic/Center |
Location | 606 1st St, Centralia, Kansas |
Authorized Official Name and Position | Todd M Willert (CEO) |
Authorized Official Contact | 7858895002 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Centralia Medical Clinic 606 1st St Centralia KS 66415-9637 Ph: (785) 857-3334 | Centralia Medical Clinic 606 1st St Centralia KS 66415-9637 Ph: (785) 857-3334 |
NPI Number | 1699747279 |
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Provider Enumeration Date | 02/07/2006 |
Last Update Date | 06/02/2020 |
Medicare PECOS PAC ID | 8325031529 |
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Medicare Enrollment ID | O20040601000073 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699747279 | NPI | - | NPPES |
001436 | Other | KS | BLUE CROSS BLUE SHIELD |
100319940A | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | H075001 (Kansas) | Primary |