| Great Bend Childrens Clinic Pa | |
|
1021 Eisenhower Ave Great Bend Children's Clinic Great Bend KS 67530-3213 | |
| (620) 792-5437 | |
| (620) 793-5245 |
| Full Name | Great Bend Childrens Clinic Pa |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1021 Eisenhower Ave, Great Bend, Kansas |
| Authorized Official Name and Position | John T. Edmonds (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 6207925437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Bend Childrens Clinic Pa 1021 Eisenhower Ave Great Bend Children's Clinic Great Bend KS 67530-3213 Ph: (620) 792-5437 | Great Bend Childrens Clinic Pa 1021 Eisenhower Ave Great Bend Children's Clinic Great Bend KS 67530-3213 Ph: (620) 792-5437 |
| NPI Number | 1619955853 |
|---|---|
| Provider Enumeration Date | 01/06/2006 |
| Last Update Date | 10/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619955853 | NPI | - | NPPES |
| 100127410B | Medicaid | KS | |
| 100299730A | Medicaid | KS | |
| 016773 | Other | KS | BCBS GROUP NO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Kansas) | Primary |
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