| A Healthy Choice Clinic | |
|
612 Broadway St Larned KS 67550-3049 | |
| (620) 285-6041 | |
| (620) 285-6149 |
| Full Name | A Healthy Choice Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 612 Broadway St, Larned, Kansas |
| Authorized Official Name and Position | Mark Ethan Van Norden (PARTNER) |
| Authorized Official Contact | 6208040385 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Healthy Choice Clinic 612 Broadway St Larned KS 67550-3049 Ph: (620) 285-6041 | A Healthy Choice Clinic 612 Broadway St Larned KS 67550-3049 Ph: (620) 285-6041 |
| NPI Number | 1912184466 |
|---|---|
| Provider Enumeration Date | 01/28/2008 |
| Last Update Date | 01/28/2008 |
| Medicare PECOS PAC ID | 7214015106 |
|---|---|
| Medicare Enrollment ID | O20080417000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912184466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 05-30418 (Kansas) | Primary |
| Provider Name | Mark Ethan Van Norden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376595959 PECOS PAC ID: 8729078456 Enrollment ID: I20040514000871 |
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