Organization
PHILLIPS COUNTY HOSPITAL
Active
Other names
Logan Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA L KELLERMAN (CLINIC ADMINISTRATOR)
(785) 543-5211
Entity
Organization
Contact information
Practice address
214 W MAIN ST, LOGAN, KS 67646-9764
(785) 689-4220
(785) 689-4219
Mailing address
214 W MAIN ST, P.O. BOX 173, LOGAN, KS 67646-9764
(785) 689-4220
(785) 689-4219
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
0433764
KS
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
44437
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100409050C
—
KS
Enumeration date
06/20/2006
Last updated
04/23/2015
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