| Crmc Medical Group - Independence | |
|
122 W Myrtle St Lowr Level Independence KS 67301-3317 | |
| (620) 577-4062 | |
| (620) 577-4064 |
| Full Name | Crmc Medical Group - Independence |
|---|---|
| Speciality | Clinic/Center |
| Location | 122 W Myrtle St Lowr Level, Independence, Kansas |
| Authorized Official Name and Position | Brian 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 |
|---|---|
| Crmc Medical Group - Independence 1400 W 4th St Coffeyville KS 67337-3306 Ph: (620) 251-1200 | Crmc Medical Group - Independence 122 W Myrtle St Lowr Level Independence KS 67301-3317 Ph: (620) 577-4062 |
| NPI Number | 1295284842 |
|---|---|
| Provider Enumeration Date | 09/23/2016 |
| Last Update Date | 03/17/2023 |
| Medicare PECOS PAC ID | 9032108865 |
|---|---|
| Medicare Enrollment ID | O20170710001364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295284842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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