Full Name | |
---|---|
Speciality | Family Medicine |
Location | 117 W 6th St, Larned, Kansas |
Authorized Official Name and Position | Larry Van Der Wege (ADMINISTRATOR) |
Authorized Official Contact | 7852273308 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
605 W Lincoln St Lindsborg KS 67456-2328 Ph: (785) 227-3308 | 117 W 6th St Larned KS 67550-3045 Ph: (620) 285-6011 |
NPI Number | 1225588379 |
---|---|
Provider Enumeration Date | 10/12/2016 |
Last Update Date | 01/11/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225588379 | NPI | - | NPPES |
016774 | Other | KS | MEDICARE ID - TYPE UNSPECIFIED |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | H-059-001 (Kansas) | Primary |
282NC0060X | General Acute Care Hospital - Critical Access | H-059-001 (Kansas) | Secondary |
Trinity Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1006 Eagle Ct, Larned, KS 67550 Phone: 620-285-2675 | |
Life Center Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 E 6th St, Larned, KS 67550 Phone: 620-804-2691 | |