Provider Demographics
NPI:1720179625
Name:HEALTH PARTNERS OF AMERICA LLC
Entity Type:Organization
Organization Name:HEALTH PARTNERS OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:620-251-5400
Mailing Address - Street 1:1411 W 4TH ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337
Mailing Address - Country:US
Mailing Address - Phone:620-251-5400
Mailing Address - Fax:620-251-5412
Practice Address - Street 1:1411 W 4TH ST
Practice Address - Street 2:SUITE G
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337
Practice Address - Country:US
Practice Address - Phone:620-251-5400
Practice Address - Fax:620-251-5412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1500239363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R30924Medicare UPIN
KS178934Medicare ID - Type UnspecifiedRURAL HEALTH CLINIC