| Ellis Medical Clinic Llc | |
|
814 Jefferson St Ellis KS 67637-2215 | |
| (785) 520-5020 | |
| (785) 520-5025 |
| Full Name | Ellis Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 814 Jefferson St, Ellis, Kansas |
| Authorized Official Name and Position | Christy Dawn Cunningham (BUSINESS MANAGER) |
| Authorized Official Contact | 7855205020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellis Medical Clinic Llc Po Box 174 Ellis KS 67637-0174 Ph: (785) 259-4261 | Ellis Medical Clinic Llc 814 Jefferson St Ellis KS 67637-2215 Ph: (785) 520-5020 |
| NPI Number | 1871064568 |
|---|---|
| Provider Enumeration Date | 12/06/2018 |
| Last Update Date | 02/16/2019 |
| Medicare PECOS PAC ID | 1254676315 |
|---|---|
| Medicare Enrollment ID | O20181218000409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871064568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Harley E Calvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124066451 PECOS PAC ID: 3476596479 Enrollment ID: I20050609000642 |
Ellis Family Care Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1000 Washington St, Ellis, KS 67637 Phone: 785-726-4956 Fax: 785-726-4479 | |
Ellis Usd 388 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Washington St, Ellis, KS 67637 Phone: 785-726-4281 Fax: 785-726-4677 |