| Minneola District Hospital Nbr 2 | |
| 
					222 Main St Bloom KS 67865-8511  | |
| (620) 885-4202 | |
| (620) 885-4805 | 
| Full Name | Minneola District Hospital Nbr 2 | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 222 Main St, Bloom, Kansas | 
| Authorized Official Name and Position | Deborah Bruner (CEO) | 
| Authorized Official Contact | 6208854264 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Minneola District Hospital Nbr 2 Po Box 127 Minneola KS 67865-0127 Ph: (620) 885-4202  | Minneola District Hospital Nbr 2 222 Main St Bloom KS 67865-8511 Ph: (620) 885-4202  | 
| NPI Number | 1811086093 | 
|---|---|
| Provider Enumeration Date | 10/12/2006 | 
| Last Update Date | 08/19/2022 | 
| Medicare PECOS PAC ID | 1355252545 | 
|---|---|
| Medicare Enrollment ID | O20051221000455 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1811086093 | NPI | - | NPPES | 
| 000422 | Other | KS | BLUE CROSS RHC | 
| 100010520H | Medicaid | KS | |
| 110485 | Other | BLUE SHIELD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | H013002 (Kansas) | Secondary | 
| 261QR1300X | Clinic/center - Rural Health | H013002 (Kansas) | Primary |