Organization
VERDIGRIS VALLEY CHRISTIAN FELLOWSHIP
Active
Other names
Verdigris Valley Charitable Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN ERIC RAYMOND APRN (CLINIC ADMINISTRATOR)
(620) 330-3922
Entity
Organization
Contact information
Practice address
215 E 13TH ST, ALTOONA, KS 66710
(620) 568-2241
Mailing address
215 E 13TH ST, ALTOONA, KS 66710
(620) 568-2241
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201082230A
—
KS
Enumeration date
09/09/2014
Last updated
09/09/2014
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