Provider Demographics
NPI:1538669346
Name:MIAMI COUNTY MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:MIAMI COUNTY MEDICAL CENTER INC.
Other - Org Name:FAMILY MEDICINE CLINICS OF MCMC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/QUALITY & COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WIENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-791-4459
Mailing Address - Street 1:2100 BAPTISTE DR
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 BAPTISTE DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1314
Practice Address - Country:US
Practice Address - Phone:913-294-2327
Practice Address - Fax:913-324-8656
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIAMI COUNTY MEDICAL CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-19
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty