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1902 May St Marysville KS 66508-1200 | |
(785) 562-3942 | |
(785) 562-5149 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1902 May St, Marysville, Kansas |
Authorized Official Name and Position | Therese M Landoll (CFO) |
Authorized Official Contact | 7855622311 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1902 May St Marysville KS 66508-1200 Ph: (785) 562-3942 | 1902 May St Marysville KS 66508-1200 Ph: (785) 562-3942 |
NPI Number | 1295749067 |
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Provider Enumeration Date | 07/28/2006 |
Last Update Date | 10/26/2007 |
Medicare PECOS PAC ID | 6608763503 |
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Medicare Enrollment ID | O20050207000014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295749067 | NPI | - | NPPES |
CE9160 | Other | KS | RAILROAD MEDICARE |
10005390G | Medicaid | KS | |
016863 | Other | KS | BLUE CROSS/BLUE SHIELD KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |