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Prairie Band Potawatomi Nation
Health Service Clinic/Center in Mayetta, Kansas
NPI 1245266410

Prairie Band Potawatomi Nation is a Health Service Clinic/Center based in Mayetta, KS and is specialized in Health Service. Prairie Band Potawatomi Nation practices in Mayetta, KS. The NPI Number for Prairie Band Potawatomi Nation is 1245266410 and holds a License No. (Kansas).

The current practice location address for Prairie Band Potawatomi Nation is 11400 158Th Rd, Mayetta, KS and can be reached out via phone at 785-966-8200 and via fax at 785-966-8393.

Location: 11400 158Th Rd, Mayetta, KS, 66509-0249
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1245266410
Provider Name
Prairie Band Potawatomi Nation
Credential
Provider Entity Type
Organization
Address
11400 158Th Rd, Mayetta, KS, 66509-0249
Phone Number
785-966-8200
Fax Number
785-966-8393
Provider Enumeration Date
06/22/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200259300A 05 KS
institution
Provider Business Practice Location Address Details
Address
11400 158Th Rd
City
Mayetta
State
Kansas
Zip
66509-0249
Phone Number
785-966-8200
Fax Number
785-966-8393
person
Provider Business Mailing Address Details
Address
11400 158Th Rd
City
Mayetta
State
Kansas
Zip
66509-0249
Phone Number
785-966-8200
Fax Number
785-966-8393
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
261QF0400X
License No.
(Kansas)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
261QH0100X
License No.
()
Definition
Definition to come...
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