Ukhs Great Bend, LLC
General Practice in Great Bend, KS. Organization (NPI-2).
NPI number1992272918
StatusActive
Last updated in NPPESMar 11, 2020
Details
- NPI
- 1992272918
- Entity type
- Organization (NPI-2)
- Legal business name
- Ukhs Great Bend, LLC
- Organization subpart
- No
- Enumeration date
- Oct 29, 2018
- Certification date
- Mar 11, 2020
- Last updated
- Mar 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 207R00000X | Internal Medicine | – | – | |
| 225100000X | Physical Therapist | – | – |
Other names
- Ukhs St. Rose Health Center (Doing Business As)
- Ukhs Great Bend St. Rose Pavilion (Doing Business As)
Practice location
3515 Broadway AveGreat Bend, KS 67530-3633
Phone 620-786-6163 · Fax 620-786-6298
Mailing address
3515 Broadway AveGreat Bend, KS 67530-3633
Phone 620-786-6163 · Fax 620-786-6298
Authorized official
Jesse Mock
Ceo
6207916272
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Other General Practice Physician providers in Great Bend, KS
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