Organization
MEDICALODGES, INC.
Active
Other names
Gran Villas Eureka
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
1820 E RIVER ST, EUREKA, KS 67045-2156
(620) 583-7473
(620) 583-7574
Mailing address
1820 E RIVER ST, EUREKA, KS 67045-2156
(620) 583-7473
(620) 583-7574
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
N037005
KS
261QA0600X
Adult Day Care Clinic/Center
Primary
N037005
KS
332B00000X
Durable Medical Equipment & Medical Supplies
N037005
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100026530X
—
KS
05
—
100068170B
—
KS
Enumeration date
10/18/2006
Last updated
06/23/2008
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