| Prul Pc Ulysses | |
|
505 N Main St Ulysses KS 67880-2135 | |
| (620) 356-1266 | |
| (620) 356-3846 |
| Full Name | Prul Pc Ulysses |
|---|---|
| Speciality | Clinic/Center |
| Location | 505 N Main St, Ulysses, Kansas |
| Authorized Official Name and Position | Angela Jo Skinner (ADMINISTRATOR, OMA) |
| Authorized Official Contact | 7206677283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prul Pc Ulysses Po Box 803929 Kansas City MO 64180-3929 Ph: (800) 953-0104 | Prul Pc Ulysses 505 N Main St Ulysses KS 67880-2135 Ph: (620) 356-1266 |
| NPI Number | 1710422795 |
|---|---|
| Provider Enumeration Date | 12/29/2016 |
| Last Update Date | 06/25/2024 |
| Medicare PECOS PAC ID | 4789595844 |
|---|---|
| Medicare Enrollment ID | O20170118000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710422795 | NPI | - | NPPES |
| 100694540D | Medicaid | OK | |
| 9000166710 | Medicaid | CO | |
| 100030210L | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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