| St Marys Clinic | |
|
206 Grand Ave St Marys KS 66536-1637 | |
| (785) 437-3734 | |
| (785) 437-6186 |
| Full Name | St Marys Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 206 Grand Ave, St Marys, Kansas |
| Authorized Official Name and Position | Todd Willert (CEO) |
| Authorized Official Contact | 7858895002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Marys Clinic 206 Grand Ave St Marys KS 66536-1637 Ph: (785) 437-3734 | St Marys Clinic 206 Grand Ave St Marys KS 66536-1637 Ph: (785) 437-3734 |
| NPI Number | 1275504839 |
|---|---|
| Provider Enumeration Date | 01/31/2006 |
| Last Update Date | 06/02/2020 |
| Medicare PECOS PAC ID | 8325031529 |
|---|---|
| Medicare Enrollment ID | O20040601000057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275504839 | NPI | - | NPPES |
| 100110130B | Medicaid | KS | |
| 001440 | Other | KS | BCBS PLAN 65 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | H075001 (Kansas) | Primary |
Jesuit Lane Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 907a E Jesuit Ln, St Marys, KS 66536 Phone: 785-437-3711 Fax: 785-437-6711 |