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Organization
MEDICALODGES, INC.
Active
Organization
MEDICALODGES, INC.
Active
Parent organization
MEDICALODGES, INC.
Other names
Medicalodges Great Bend
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICALODGES, INC.
Authorized official
MR. SCOTT HINES (CFO)
(620) 709-0305
Entity
Organization
Contact information
Practice address
1401 CHERRY LN, GREAT BEND, KS 67530-3152
(620) 792-2165
Mailing address
PO BOX 509, COFFEYVILLE, KS 67337-0509
(620) 251-6700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100107470A
—
KS
Enumeration date
06/25/2018
Last updated
12/27/2018
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