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1110 Columbine Dr Ste 100 Holton KS 66436-8824 | |
(785) 364-2126 | |
(785) 364-2801 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1110 Columbine Dr Ste 100, Holton, Kansas |
Authorized Official Name and Position | Carrie L Saia (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 7853642116 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1110 Columbine Dr Ste 100 Holton KS 66436-8824 Ph: (785) 364-2126 | 1110 Columbine Dr Ste 100 Holton KS 66436-8824 Ph: (785) 364-2126 |
NPI Number | 1639145204 |
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Provider Enumeration Date | 02/24/2006 |
Last Update Date | 11/06/2023 |
Medicare PECOS PAC ID | 7810807690 |
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Medicare Enrollment ID | O20030505000059 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639145204 | NPI | - | NPPES |
100244350E | Medicaid | KS | |
100244350B | Medicaid | KS | |
110707 | Other | KS | BLUE CORSS GROUP PROVIDER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Kansas) | Secondary |
261QR1300X | Clinic/center - Rural Health | H-043-001 (Kansas) | Primary |
Rainbow Hill Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 713 W 7th St, Holton, KS 66436 Phone: 785-364-4445 Fax: 785-364-4934 | |