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712a Saint John St Garden City KS 67846-5128 | |
(620) 275-1766 | |
(620) 275-4729 |
Full Name | |
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Speciality | Clinic/Center |
Location | 712a Saint John St, Garden City, Kansas |
Authorized Official Name and Position | Julie K Wright (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6202717400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 766 Garden City KS 67846-0766 Ph: (620) 271-7400 | 712a Saint John St Garden City KS 67846-5128 Ph: (620) 275-1766 |
NPI Number | 1730174228 |
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Provider Enumeration Date | 09/12/2005 |
Last Update Date | 11/23/2022 |
Medicare PECOS PAC ID | 7416866124 |
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Medicare Enrollment ID | O20110620000211 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730174228 | NPI | - | NPPES |
100314080B | Medicaid | KS | |
CH07463A | Other | 340B ID | |
001421 | Other | KS | BC/BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
332900000X | Non-pharmacy Dispensing Site | (* (Not Available)) | Secondary |
Plaza Medical Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 911 N Main St, Garden City, KS 67846 Phone: 620-276-8201 Fax: 620-275-0712 |