Organization
MEDICALODGES, INC.
Active
Other names
Medicalodges Frontenac
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT L HINES (CHIEF FINANCIAL OFFICER)
(620) 709-0305
Entity
Organization
Contact information
Practice address
206 S DITTMAN ST, FRONTENAC, KS 66763-2253
(620) 231-7340
(620) 231-3955
Mailing address
206 S DITTMAN ST, FRONTENAC, KS 66763-2253
(620) 231-7340
(620) 231-3955
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N019007
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100107330L
—
KS
Enumeration date
02/07/2013
Last updated
10/25/2013
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