Organization
MEDICALODGES, INC.
Active
Other names
Medicalodges Coffeyville
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY W FISHER (CHIEF FINANCIAL OFFICER)
(620) 251-6700
Entity
Organization
Contact information
Practice address
720 W 1ST ST, COFFEYVILLE, KS 67337-3854
(620) 251-3705
(620) 251-2410
Mailing address
720 W 1ST ST, COFFEYVILLE, KS 67337-3854
(620) 251-3705
(620) 251-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N063006
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100108830A
—
KS
Enumeration date
03/23/2006
Last updated
10/21/2008
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