Provider Demographics
NPI:1780391409
Name:AMBERWELL ATCHISON ASSOCIATION
Entity type:Organization
Organization Name:AMBERWELL ATCHISON ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-367-2131
Mailing Address - Street 1:800 RAVENHILL DR
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-9204
Mailing Address - Country:US
Mailing Address - Phone:913-367-2131
Mailing Address - Fax:
Practice Address - Street 1:1004 PROGRESS DR STE 180&145
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-6326
Practice Address - Country:US
Practice Address - Phone:913-297-3215
Practice Address - Fax:913-297-2732
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBERWELL ATCHISON ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-02
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health