Tlc Family Health | |
2508 Edgemont Dr Ste 3 Arkansas City KS 67005-3844 | |
(620) 741-5430 | |
Not Available |
Full Name | Tlc Family Health |
---|---|
Speciality | Nurse Practitioner |
Location | 2508 Edgemont Dr Ste 3, Arkansas City, Kansas |
Authorized Official Name and Position | Tammy L Cullum (OWNER) |
Authorized Official Contact | 6207415430 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tlc Family Health 11663 182nd Rd Winfield KS 67156-7907 Ph: (620) 222-1248 | Tlc Family Health 2508 Edgemont Dr Ste 3 Arkansas City KS 67005-3844 Ph: (620) 741-5430 |
NPI Number | 1194505776 |
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Provider Enumeration Date | 10/02/2023 |
Last Update Date | 09/13/2024 |
Medicare PECOS PAC ID | 8325493869 |
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Medicare Enrollment ID | O20231018002146 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194505776 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | Tammy Cullum |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699309120 PECOS PAC ID: 2668801564 Enrollment ID: I20200327002130 |
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