Full Name | |
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Speciality | Clinic/Center |
Location | 118 S Wabash St, Howard, Kansas |
Authorized Official Name and Position | Thomas N Henton (CEO) |
Authorized Official Contact | 6205837451 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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118 S Wabash St Howard KS 67349 Ph: (620) 374-2650 | 118 S Wabash St Howard KS 67349 Ph: (620) 374-2650 |
NPI Number | 1114035102 |
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Provider Enumeration Date | 08/29/2006 |
Last Update Date | 02/10/2014 |
Medicare PECOS PAC ID | 0042129603 |
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Medicare Enrollment ID | O20070417000546 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114035102 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |