Full Name | |
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Speciality | Clinic/Center |
Location | 112 N. Kansas, Selden, Kansas |
Authorized Official Name and Position | Joseph A. Stratton (CEO/ADMINISTRATOR) |
Authorized Official Contact | 7856753281 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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826 18th Street Hoxie KS 67740-0415 Ph: (785) 675-3018 | 112 N. Kansas Selden KS 67757 Ph: (785) 386-4380 |
NPI Number | 1114033966 |
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Provider Enumeration Date | 08/22/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 7416842380 |
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Medicare Enrollment ID | O20160930000678 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114033966 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |