Minneola Community Clinic | |
222 Main St Bloom KS 67865-8511 | |
(620) 885-4202 | |
(620) 885-4805 |
Full Name | Minneola Community Clinic |
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Speciality | Clinic/Center |
Location | 222 Main St, Bloom, Kansas |
Authorized Official Name and Position | Deborah Bruner (CEO) |
Authorized Official Contact | 6208854264 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Minneola Community Clinic Po Box 127 Minneola KS 67865-0127 Ph: (620) 885-4202 | Minneola Community Clinic 222 Main St Bloom KS 67865-8511 Ph: (620) 885-4202 |
NPI Number | 1811086093 |
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Provider Enumeration Date | 10/12/2006 |
Last Update Date | 08/19/2022 |
Medicare PECOS PAC ID | 1355252545 |
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Medicare Enrollment ID | O20051221000455 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811086093 | NPI | - | NPPES |
000422 | Other | KS | BLUE CROSS RHC |
100010520H | Medicaid | KS | |
110485 | Other | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | H013002 (Kansas) | Secondary |
261QR1300X | Clinic/center - Rural Health | H013002 (Kansas) | Primary |