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Organization

GREAT PLAINS OF ELLINWOOD INC.

Active
Other names
Ellinwood Hospital Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KILE MAGNER (CHIEF EXECUTIVE OFFICER)
(620) 564-2548
Entity
Organization

Contact information

Practice address
300 N PARK AVE, ELLINWOOD, KS 67526-1452
(620) 564-2548
(620) 564-2491
Mailing address
300 N PARK AVE, ELLINWOOD, KS 67526-1452
(620) 564-2548
(620) 564-2491

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000964
BCBS 2NDRY FOR RHC
KS
05
1000410070B
KS
01
110746
BLUE CROSS
KS
01
173402
MEDICARE PTAN
KS
Enumeration date
08/11/2006
Last updated
07/17/2024
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