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120 W Josephine Ave Augusta KS 67010-2037 | |
(316) 775-5432 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 120 W Josephine Ave, Augusta, Kansas |
Authorized Official Name and Position | Suzann M Wright (DIRECTOR,PATIENT FINANCIAL SERVICES) |
Authorized Official Contact | 3166899617 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 8035 Wichita KS 67208-0035 Ph: (316) 689-9135 | 120 W Josephine Ave Augusta KS 67010-2037 Ph: (316) 775-5432 |
NPI Number | 1023110822 |
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Provider Enumeration Date | 09/02/2006 |
Last Update Date | 12/19/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023110822 | NPI | - | NPPES |
5912199402 | Medicaid | KS | |
000933 | Other | KS | BCBS |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Authentic Living Counseling Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7939 Sw 163rd St, Augusta, KS 67010 Phone: 360-899-8577 | |