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2330 N Kansas Ave Liberal KS 67901-2372 | |
(620) 624-0463 | |
(620) 624-7313 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2330 N Kansas Ave, Liberal, 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 | 2330 N Kansas Ave Liberal KS 67901-2372 Ph: (620) 624-0463 |
NPI Number | 1871789719 |
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Provider Enumeration Date | 09/24/2007 |
Last Update Date | 04/27/2022 |
Medicare PECOS PAC ID | 7416866124 |
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Medicare Enrollment ID | O20110620000196 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871789719 | NPI | - | NPPES |
CH07463B | Other | HRSA OFFICE OF PHARMACY AFFAIRS 340B PROGRAM | |
100314080E | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
332900000X | Non-pharmacy Dispensing Site | (* (Not Available)) | Secondary |
High Plains Medical Specialists Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Plaza Dr, Liberal, KS 67901 Phone: 620-624-5691 Fax: 620-624-3656 | |
Ian F Yeats M.d. Chartered Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1411 W 15th St Ste 102, Liberal, KS 67901 Phone: 620-624-0142 Fax: 620-624-2660 | |
Gill Internal Medicine L.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 E Tucker Rd Ste F, Liberal, KS 67901 Phone: 620-624-1100 |