Provider Demographics
NPI:1679902126
Name:NEOSHO MEMORIAL REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:NEOSHO MEMORIAL REGIONAL MEDICAL CENTER
Other - Org Name:NMRMC ERIE FAMILY CARE CLINIC
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:620-431-4000
Mailing Address - Fax:620-431-7556
Practice Address - Street 1:13920 HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:KS
Practice Address - Zip Code:66733-5001
Practice Address - Country:US
Practice Address - Phone:620-244-5105
Practice Address - Fax:620-244-5111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
KSH-067-001261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care