Provider Demographics
NPI:1376314435
Name:ADVANCED PRIMARY CARE CLINIC INC
Entity Type:Organization
Organization Name:ADVANCED PRIMARY CARE CLINIC INC
Other - Org Name:ADVANCED PRIMARY CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ECHARD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:620-674-1029
Mailing Address - Street 1:120 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:KS
Mailing Address - Zip Code:66725-1705
Mailing Address - Country:US
Mailing Address - Phone:620-429-1008
Mailing Address - Fax:620-429-3780
Practice Address - Street 1:120 W PINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:KS
Practice Address - Zip Code:66725-1705
Practice Address - Country:US
Practice Address - Phone:620-429-1008
Practice Address - Fax:620-429-3780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care