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620 W 8th St Kinsley KS 67547-2329 | |
(620) 659-3621 | |
(620) 659-3869 |
Full Name | |
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Speciality | Clinic/Center |
Location | 620 W 8th St, Kinsley, Kansas |
Authorized Official Name and Position | Jimmie Hansel (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6206593621 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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620 W 8th St Kinsley KS 67547-2329 Ph: (620) 659-3621 | 620 W 8th St Kinsley KS 67547-2329 Ph: (620) 659-3621 |
NPI Number | 1649372012 |
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Provider Enumeration Date | 09/05/2006 |
Last Update Date | 08/30/2022 |
Medicare PECOS PAC ID | 2264343383 |
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Medicare Enrollment ID | O20030917000019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649372012 | NPI | - | NPPES |
016623 | Other | BLUE CROSS BLUE SHIELD | |
100009380A | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 173495 (Kansas) | Primary |