Organization
COUNTY OF MORTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RHIANNA S SHAW RN (ADMINISTRATOR)
(620) 697-2612
Entity
Organization
Contact information
Practice address
625 COLORADO STREET, ELKHART, KS 67950-0973
(620) 697-2612
(620) 697-2790
Mailing address
625 COLORADO STREET, ELKHART, KS 67950-0973
(620) 697-2612
(620) 697-2790
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12789
BLUE CROSS & BLUE SHILED
KS
Enumeration date
11/01/2006
Last updated
06/17/2013
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