Organization Name: | MEDICALODGES, INC. |
NPI Number: | 1578633715 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CATHY W FISHER (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 411 S Summit St Arkansas City |
State: | KS US |
Postal Code: | 670052850 |
Phone Number: | 6204420007 |
Fax Number: | 6204424662 |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 06/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | A-018-008 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |