| Coffeyville Regional Medical Center Inc | |
|
1400 W 4th St Ste 100 Coffeyville KS 67337-3306 | |
| (620) 688-6566 | |
| Not Available |
| Full Name | Coffeyville Regional Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1400 W 4th St, Coffeyville, Kansas |
| Authorized Official Name and Position | Brian H Lawrence (CEO) |
| Authorized Official Contact | 6202511200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coffeyville Regional Medical Center Inc 1400 W 4th St Coffeyville KS 67337-3306 Ph: (620) 251-1200 | Coffeyville Regional Medical Center Inc 1400 W 4th St Ste 100 Coffeyville KS 67337-3306 Ph: (620) 688-6566 |
| NPI Number | 1053862805 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 03/17/2023 |
| Medicare PECOS PAC ID | 9032108865 |
|---|---|
| Medicare Enrollment ID | O20161118000585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053862805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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