Provider Demographics
NPI:1497121735
Name:NEOSHO MEMORIAL REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:NEOSHO MEMORIAL REGIONAL MEDICAL CENTER
Other - Org Name:NMRMC FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:TINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-431-4000
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-0426
Mailing Address - Country:US
Mailing Address - Phone:620-432-5588
Mailing Address - Fax:620-431-1192
Practice Address - Street 1:1501 W 7TH ST STE 2
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-2516
Practice Address - Country:US
Practice Address - Phone:620-432-5588
Practice Address - Fax:620-431-1192
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEOSHO MEMORIAL REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-20
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100009390CMedicaid