Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 302 Pearson Ave, Waverly, Kansas |
Authorized Official Name and Position | Merri Michaels (BILLING MANAGER) |
Authorized Official Contact | 6203642121 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 289 Burlington KS 66839-0289 Ph: (620) 364-5395 | 302 Pearson Ave Waverly KS 66871 Ph: (785) 733-2867 |
NPI Number | 1578645628 |
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Provider Enumeration Date | 10/19/2006 |
Last Update Date | 01/15/2019 |
Medicare PECOS PAC ID | 4981598653 |
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Medicare Enrollment ID | O20070312000504 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578645628 | NPI | - | NPPES |
100098740D | Medicaid | KS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Kansas) | Primary |