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1117 Goldfinch Rd Horton KS 66439-9537 | |
(785) 486-2154 | |
(785) 486-2158 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1117 Goldfinch Rd, Horton, Kansas |
Authorized Official Name and Position | Ashley Santer (ADMINISTRATION) |
Authorized Official Contact | 7854862154 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1117 Goldfinch Rd Horton KS 66439-9537 Ph: (785) 486-2154 | 1117 Goldfinch Rd Horton KS 66439-9537 Ph: (785) 486-2154 |
NPI Number | 1992806012 |
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Provider Enumeration Date | 09/25/2006 |
Last Update Date | 04/24/2024 |
Medicare PECOS PAC ID | 0749228930 |
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Medicare Enrollment ID | O20151125000247 |
Identifier | Type | State | Issuer |
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1992806012 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |
Provider Name | Michelle L Koch-shamburg |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386740892 PECOS PAC ID: 6103857032 Enrollment ID: I20190722003401 |
Provider Name | Richard L Brown |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1114029428 PECOS PAC ID: 7911938733 Enrollment ID: I20190910000241 |