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200 Carroll St St Paul KS 66771-4044 | |
(620) 449-2582 | |
(620) 449-2587 |
Full Name | |
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Speciality | Clinic/Center |
Location | 200 Carroll St, St Paul, Kansas |
Authorized Official Name and Position | Thomas L Macaronas (CFO/COO) |
Authorized Official Contact | 6208205251 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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200 Carroll St St Paul KS 66771-4044 Ph: (620) 449-2582 | 200 Carroll St St Paul KS 66771-4044 Ph: (620) 449-2582 |
NPI Number | 1710985429 |
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Provider Enumeration Date | 07/07/2005 |
Last Update Date | 10/04/2017 |
Medicare PECOS PAC ID | 5496664369 |
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Medicare Enrollment ID | O20040114000669 |
Identifier | Type | State | Issuer |
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1710985429 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |