Organization
COMMUNITY MEMORIAL HEALTHCARE, INC.
Active
Parent organization
COMMUNITY MEMORIAL HEALTHCARE, INC.
Other names
Community Physicians 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
1902 MAY ST, MARYSVILLE, KS 66508-1200
(785) 562-3942
(785) 562-5149
Mailing address
1902 MAY ST, MARYSVILLE, KS 66508-1200
(785) 562-3942
(785) 562-5149
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
—
016863
BLUE CROSS/BLUE SHIELD KS
KS
05
—
10005390G
—
KS
01
—
CE9160
RAILROAD MEDICARE
KS
Enumeration date
07/28/2006
Last updated
10/26/2007
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