| Gracemed Healthy Family Clinic | |
|
1905 S Laura St Wichita KS 67211-4422 | |
| (316) 866-2000 | |
| (316) 866-2084 |
| Full Name | Gracemed Healthy Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1905 S Laura St, Wichita, Kansas |
| Authorized Official Name and Position | Venus Lee (CEO) |
| Authorized Official Contact | 3168662064 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gracemed Healthy Family Clinic 1122 N Topeka St Wichita KS 67214-2810 Ph: (316) 866-2000 | Gracemed Healthy Family Clinic 1905 S Laura St Wichita KS 67211-4422 Ph: (316) 866-2000 |
| NPI Number | 1356777114 |
|---|---|
| Provider Enumeration Date | 09/24/2013 |
| Last Update Date | 02/14/2022 |
| Medicare PECOS PAC ID | 9830098185 |
|---|---|
| Medicare Enrollment ID | O20220413000570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356777114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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