| Northeast Kansas Center For Health And Wellness, Inc. | |
|
240 W 18th St Horton KS 66439-1245 | |
| (785) 486-2642 | |
| (785) 486-2842 |
| Full Name | Northeast Kansas Center For Health And Wellness, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 240 W 18th St, Horton, 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. 240 W 18th St Horton KS 66439-1245 Ph: (785) 486-2642 |
| NPI Number | 1750325197 |
|---|---|
| Provider Enumeration Date | 06/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750325197 | NPI | - | NPPES |
| 426980 | Other | KS | BLUE SHIELD |
| 161636 | Other | KS | BLUE SHIELD |
| 426996 | Other | KS | BLUE SHIELD |
| 664990 | Other | KS | FIRST GUARD HEALTH PLAN |
| 927587 | Other | KS | FIRST GUARD HEALTH PLAN |
| 928432 | Other | KS | FIRST GUARD HEALTH PLAN |
| 105445 | Other | KS | BLUE SHIELD |
| 042154 | Other | KS | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H-007-002 (Kansas) | Primary |
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