| Embold Foot Care Llc | |
|
981 3600 Ave Abilene KS 67410-6044 | |
| (785) 479-6401 | |
| Not Available |
| Full Name | Embold Foot Care Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 981 3600 Ave, Abilene, Kansas |
| Authorized Official Name and Position | Chantell Debenham (OWNER/PROVIDER) |
| Authorized Official Contact | 7855769990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Embold Foot Care Llc 981 3600 Ave Abilene KS 67410-6044 Ph: (785) 576-9990 | Embold Foot Care Llc 981 3600 Ave Abilene KS 67410-6044 Ph: (785) 479-6401 |
| NPI Number | 1831804764 |
|---|---|
| Provider Enumeration Date | 01/16/2023 |
| Last Update Date | 02/02/2023 |
| Medicare PECOS PAC ID | 0345613378 |
|---|---|
| Medicare Enrollment ID | O20230222001675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831804764 | NPI | - | NPPES |
| 1215247416 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Chantell R Debenham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215247416 PECOS PAC ID: 2163617986 Enrollment ID: I20101105001088 |
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