| Jane Phillips Coffeyville Rural Health Clinic | |
|
1505 W 4th St Suite C Coffeyville KS 67337-3307 | |
| (620) 251-5400 | |
| (620) 251-5412 |
| Full Name | Jane Phillips Coffeyville Rural Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1505 W 4th St, Coffeyville, Kansas |
| Authorized Official Name and Position | Gayle J Burden (DIRECTOR) |
| Authorized Official Contact | 9183311090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jane Phillips Coffeyville Rural Health Clinic 1505 W 11th St Suite C Coffeyville KS 67337-3613 Ph: (620) 251-5400 | Jane Phillips Coffeyville Rural Health Clinic 1505 W 4th St Suite C Coffeyville KS 67337-3307 Ph: (620) 251-5400 |
| NPI Number | 1669792818 |
|---|---|
| Provider Enumeration Date | 06/09/2010 |
| Last Update Date | 08/09/2016 |
| Medicare PECOS PAC ID | 2567366495 |
|---|---|
| Medicare Enrollment ID | O20150429001424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669792818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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