Organization Name: | PANACEA FAMILY MEDICINE, PA |
NPI Number: | 1285681577 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VERDON W PARHAM (OWNER) |
Mailing Address: | 629 S Plummer Ave Chanute |
State: | KS US |
Postal Code: | 667201928 |
Phone Number: | 6204325588 |
Fax Number: | 6204325593 |
NPI Enumeration Date: | 05/30/2006 |
NPI Last Update Date: | 03/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |