| Shawnee Family Care Pa | |
|
5949 Nieman Rd Shawnee KS 66203-2907 | |
| (913) 631-6114 | |
| (913) 631-5263 |
| Full Name | Shawnee Family Care Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5949 Nieman Rd, Shawnee, Kansas |
| Authorized Official Name and Position | Martha A Ward (OFFICE MANAGER) |
| Authorized Official Contact | 9136316114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawnee Family Care Pa 5949 Nieman Rd Shawnee KS 66203-2907 Ph: (913) 631-6114 | Shawnee Family Care Pa 5949 Nieman Rd Shawnee KS 66203-2907 Ph: (913) 631-6114 |
| NPI Number | 1174667174 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174667174 | NPI | - | NPPES |
| CB6830 | Other | KS | MEDICARE RR GROUP |
| H24932 | Other | KS | UPIN MARY K DEVERS |
| 27992017 | Other | KS | BLUE SHIELD GROUP |
| E66004 | Other | KS | JOHN L CRANE UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0423330 (Kansas) | Primary |
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