Provider Demographics
NPI:1326512450
Name:HEALTH MINISTRIES CLINIC, INC.
Entity Type:Organization
Organization Name:HEALTH MINISTRIES CLINIC, INC.
Other - Org Name:HEALTH MINISTRIES CLINIC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:T
Authorized Official - Last Name:ATTEBERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-284-5151
Mailing Address - Street 1:720 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-8778
Mailing Address - Country:US
Mailing Address - Phone:316-284-5151
Mailing Address - Fax:316-284-5161
Practice Address - Street 1:720 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-8778
Practice Address - Country:US
Practice Address - Phone:316-283-6103
Practice Address - Fax:316-283-1333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH MINISTRIES CLINIC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-11
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200400490GMedicaid