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302 Pearson Ave Waverly KS 66871-9676 | |
(785) 733-2667 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 302 Pearson Ave, Waverly, Kansas |
Authorized Official Name and Position | Merri Michaels (BILLING SUPERVISOR) |
Authorized Official Contact | 6203642121 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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801 N 4th St P.o. Box 189 Burlington KS 66839-2602 Ph: (620) 364-2121 | 302 Pearson Ave Waverly KS 66871-9676 Ph: (785) 733-2667 |
NPI Number | 1013905405 |
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Provider Enumeration Date | 10/10/2005 |
Last Update Date | 01/15/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013905405 | NPI | - | NPPES |
180038 | Other | KS | BLUE CROSS BLUE SHIELD |
100098820B | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |