| Heartland Medical Clinic, Inc. | |
|
1312 W 6th St Lawrence KS 66044-2219 | |
| (785) 841-7297 | |
| (785) 856-0375 |
| Full Name | Heartland Medical Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1312 W 6th St, Lawrence, Kansas |
| Authorized Official Name and Position | Julie Branstrom (CEO) |
| Authorized Official Contact | 7858417297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Medical Clinic, Inc. 1312 W 6th St Lawrence KS 66044-2219 Ph: (785) 841-7297 | Heartland Medical Clinic, Inc. 1312 W 6th St Lawrence KS 66044-2219 Ph: (785) 841-7297 |
| NPI Number | 1487107447 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 06/18/2024 |
| Medicare PECOS PAC ID | 2769477645 |
|---|---|
| Medicare Enrollment ID | O20211011000403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487107447 | NPI | - | NPPES |
| 200688980A | Medicaid | KS | |
| 30003936890001 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Kansas) | Secondary |
| 208000000X | Pediatrics | (Kansas) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Kansas) | Primary |
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