Healthcare Provider Details

I. General information

NPI: 1881787075
Provider Name (Legal Business Name): DODGE CITY HEALTHCARE GROUP LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 AVENUE A
DODGE CITY KS
67801-2270
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-4536
US

V. Phone/Fax

Practice location:
  • Phone: 620-225-8401
  • Fax: 620-225-8403
Mailing address:
  • Phone: 615-920-7000
  • Fax: 615-920-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ROBERT N KLEIN
Title or Position: PRESIDENT
Credential:
Phone: 615-920-7000