Provider Demographics
NPI:1538128558
Name:RURAL MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:RURAL MEDICAL SERVICES, INC
Other - Org Name:SNODGRASS RURAL MEDICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BLIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-285-6424
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:200 E 8TH STREET
Mailing Address - City:LARNED
Mailing Address - State:KS
Mailing Address - Zip Code:67550-0129
Mailing Address - Country:US
Mailing Address - Phone:620-285-6424
Mailing Address - Fax:620-285-3660
Practice Address - Street 1:200 E 8TH ST
Practice Address - Street 2:
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550-2602
Practice Address - Country:US
Practice Address - Phone:620-285-6424
Practice Address - Fax:620-285-3660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS173870Medicare Oscar/Certification
KS110343Medicare ID - Type UnspecifiedMEDICARE