| Community Health Center Of Southeast Kansas, Inc. | |
|
7 S 1st St Wyandotte OK 74370-2268 | |
| (620) 231-9873 | |
| Not Available |
| Full Name | Community Health Center Of Southeast Kansas, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 7 S 1st St, Wyandotte, Oklahoma |
| Authorized Official Name and Position | Daniel Spencer Creitz (GENERAL COUNSEL) |
| Authorized Official Contact | 6202405015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Southeast Kansas, Inc. 3011 N Michigan St Pittsburg KS 66762-2546 Ph: (620) 231-9873 | Community Health Center Of Southeast Kansas, Inc. 7 S 1st St Wyandotte OK 74370-2268 Ph: (620) 231-9873 |
| NPI Number | 1013567940 |
|---|---|
| Provider Enumeration Date | 09/12/2019 |
| Last Update Date | 09/12/2019 |
| Medicare PECOS PAC ID | 7911816392 |
|---|---|
| Medicare Enrollment ID | O20190924002900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013567940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Wyandotte Nation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Turtle Drive, Wyandotte, OK 74370 Phone: 918-678-2282 Fax: 918-678-2759 |