Organization
COMMUNITY MEMORIAL HEALTHCARE, INC.
Active
Parent organization
COMMUNITY MEMORIAL HEALTHCARE, INC
Other names
Marysville Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY MEMORIAL HEALTHCARE, INC
Authorized official
THERESE M LANDOLL (CFO)
(785) 562-2311
Entity
Organization
Contact information
Practice address
808 N 19TH ST, MARYSVILLE, KS 66508-1358
(785) 562-2303
(785) 562-2034
Mailing address
808 N 19TH ST, MARYSVILLE, KS 66508-1358
(785) 562-2303
(785) 562-2034
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110007
BLUE CROSS/BLUE SHIELD KS
KS
01
—
CD1965
RAILROAD MEDICARE
—
Enumeration date
07/21/2006
Last updated
04/20/2008
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