| Northeast Kansas Center For Health And Wellness, Inc. | |
| 
					517 Main St Everest KS 66424  | |
| (785) 548-7610 | |
| (785) 486-2842 | 
| Full Name | Northeast Kansas Center For Health And Wellness, Inc. | 
|---|---|
| Speciality | Family Medicine | 
| Location | 517 Main St, Everest, Kansas | 
| Authorized Official Name and Position | Dale A White (CEO) | 
| Authorized Official Contact | 7854862642 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Northeast Kansas Center For Health And Wellness, Inc. 240 W 18th St Horton KS 66439-1245 Ph: (785) 486-2642  | Northeast Kansas Center For Health And Wellness, Inc. 517 Main St Everest KS 66424 Ph: (785) 548-7610  | 
| NPI Number | 1710923842 | 
|---|---|
| Provider Enumeration Date | 06/20/2006 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1710923842 | NPI | - | NPPES | 
| 110054 | Other | KS | BLUE SHIELD | 
| 105444 | Other | KS | BLUE SHIELD | 
| 426715 | Other | KS | BLUE SHIELD | 
| 928432 | Other | KS | FIRST GUARD HEALTH PLAN | 
| 426979 | Other | KS | BLUE SHIELD | 
| 426995 | Other | KS | BLUE SHIELD | 
| 664990 | Other | KS | FIRST GUARD HEALTH PLAN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | H-007-002 (Kansas) | Primary | 
Cah Acquisition Company 3 Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 517 Main St, Everest, KS 66424 Phone: 785-548-7610 Fax: 785-486-2842  |