# MEDICALODGES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDICALODGES, INC.
- **Other names:** Medicalodges Great Bend
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669967436
- **Legal business name:** MEDICALODGES, INC.
- **Authorized official:** MR. SCOTT HINES (CFO)
- **Authorized official phone:** (620) 709-0305

## Contact information

- **Practice address:** 1401 CHERRY LN, GREAT BEND, KS 67530-3152
- **Practice address phone:** (620) 792-2165
- **Mailing address:** PO BOX 509, COFFEYVILLE, KS 67337-0509
- **Mailing address phone:** (620) 251-6700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 06/25/2018
- **Last updated:** 12/27/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100107470A | — | KS |