Organization
MIDWEST FAMILY HEALTH OF RUSSELL LLC
Active
Other names
Midwest Family Health
Organization subpart
No
Provider details
NPI number
Authorized official
STACIE RICKER (OWNER)
(785) 540-4143
Entity
Organization
Contact information
Practice address
208 S FOSSIL ST, RUSSELL, KS 67665-3021
(785) 483-2119
(785) 483-2248
Mailing address
PO BOX 608, PHILLIPSBURG, KS 67661-0608
(785) 540-4143
(785) 540-4314
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-13248
KS
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141160
PK
—
05
—
30003907790001
—
KS
05
—
30003907790002
—
KS
Enumeration date
07/11/2013
Last updated
03/25/2025
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