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536 W 4th Ave Garnett KS 66032-1355 | |
| (785) 448-2674 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 536 W 4th Ave, Garnett, Kansas |
| Authorized Official Name and Position | Erin Parde (CFO) |
| Authorized Official Contact | 8168805277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 309 Garnett KS 66032-0309 Ph: (785) 448-2674 | 536 W 4th Ave Garnett KS 66032-1355 Ph: (785) 448-2674 |
| NPI Number | 1598739948 |
|---|---|
| Provider Enumeration Date | 02/14/2006 |
| Last Update Date | 11/25/2024 |
| Medicare PECOS PAC ID | 8729071691 |
|---|---|
| Medicare Enrollment ID | O20061026000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598739948 | NPI | - | NPPES |
| 100294110C | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | H002001 (Kansas) | Primary |
Pheasant Ridge Family Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 312 S Maple St, Garnett, KS 66032 Phone: 785-787-5050 | |
Community Health Center Of Southeast Kansas, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 312 S Maple St, Garnett, KS 66032 Phone: 888-777-9170 | |