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Organization

OLATHE COMMUNITY CLINIC INC

Active
Other names
River Valley Family Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
KAYE HOTSENPILLER (COO)
(970) 323-6141
Entity
Organization

Contact information

Practice address
308 MAIN STREET, OLATHE, CO 81425
(970) 323-6141
(855) 299-8071
Mailing address
PO BOX 529, OLATHE, CO 81425-0529
(970) 323-6141
(855) 299-8071

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
261QM1300X
Multi-Specialty Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
061930
MEDICARE A PTAN
CO
01
294943
MEDICARE B PTAN
CO
01
617703000
DEPT OF LABOR, OLATHE ONLY
CO
01
619803300
DEPT OF LABOR, MONTROSE ONLY
CO
01
DU5283
RAILROAD WORKERS MEDICARE
CO
05
OLATHE ONLY: 9890527
CO
Enumeration date
09/25/2012
Last updated
03/18/2025
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