| Heart Of Kansas Family Health Care, Inc. | |
|
1905 19th St. Great Bend KS 67530 | |
| (620) 792-5700 | |
| (620) 792-5742 |
| Full Name | Heart Of Kansas Family Health Care, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1905 19th St., Great Bend, Kansas |
| Authorized Official Name and Position | Heather Hicks (QI COORD.) |
| Authorized Official Contact | 6207925700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Of Kansas Family Health Care, Inc. 1905 19th St. Great Bend KS 67530 Ph: (620) 792-5700 | Heart Of Kansas Family Health Care, Inc. 1905 19th St. Great Bend KS 67530 Ph: (620) 792-5700 |
| NPI Number | 1184739443 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 04/21/2022 |
| Medicare PECOS PAC ID | 4486565181 |
|---|---|
| Medicare Enrollment ID | O20030911000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184739443 | NPI | - | NPPES |
| 160510 | Other | KS | BLUE SHIELD |
| 30003932810007 | Medicaid | KS | |
| 461035 | Other | KS | CHILDRENS MERCY |
| DC6555 | Other | KS | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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