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111 W Spring Ave Conway Springs KS 67031-3100 | |
(620) 456-2411 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 111 W Spring Ave, Conway Springs, Kansas |
Authorized Official Name and Position | Lori Allen (CFO) |
Authorized Official Contact | 6208425111 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1101 E Spring St Anthony KS 67003-2122 Ph: () - | 111 W Spring Ave Conway Springs KS 67031-3100 Ph: (620) 456-2411 |
NPI Number | 1013436260 |
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Provider Enumeration Date | 09/19/2017 |
Last Update Date | 09/19/2017 |
Medicare PECOS PAC ID | 3779571906 |
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Medicare Enrollment ID | O20171115001626 |
Identifier | Type | State | Issuer |
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1013436260 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |