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203 W Main St Cherryvale KS 67335-1332 | |
(620) 336-2131 | |
(620) 336-2237 |
Full Name | |
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Speciality | Clinic/Center |
Location | 203 W Main St, Cherryvale, Kansas |
Authorized Official Name and Position | Lori C Smith (CFO) |
Authorized Official Contact | 6203258388 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 360 Neodesha KS 66757-0360 Ph: (620) 325-2611 | 203 W Main St Cherryvale KS 67335-1332 Ph: (620) 336-2131 |
NPI Number | 1598121790 |
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Provider Enumeration Date | 01/05/2016 |
Last Update Date | 09/25/2024 |
Medicare PECOS PAC ID | 2163656208 |
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Medicare Enrollment ID | O20160215000508 |
Identifier | Type | State | Issuer |
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1598121790 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |