| Stafford Clinic Site | |
|
412 Grand Ave Stafford KS 67578-2010 | |
| (620) 792-5700 | |
| Not Available |
| Full Name | Stafford Clinic Site |
|---|---|
| Speciality | Clinic/Center |
| Location | 412 Grand Ave, Stafford, Kansas |
| Authorized Official Name and Position | Jyl Nokes (CO) |
| Authorized Official Contact | 6207925700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stafford Clinic Site 1905 19th St Great Bend KS 67530-2502 Ph: (620) 792-5700 | Stafford Clinic Site 412 Grand Ave Stafford KS 67578-2010 Ph: (620) 792-5700 |
| NPI Number | 1255856258 |
|---|---|
| Provider Enumeration Date | 08/10/2017 |
| Last Update Date | 11/08/2017 |
| Medicare PECOS PAC ID | 4486565181 |
|---|---|
| Medicare Enrollment ID | O20171110000221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255856258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Stafford County Hospital Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 412 Grand Ave, Stafford, KS 67578 Phone: 620-234-5221 Fax: 620-234-5792 |