Healthcare Provider Details

I. General information

NPI: 1538128558
Provider Name (Legal Business Name): RURAL MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 8TH ST
LARNED KS
67550-2602
US

IV. Provider business mailing address

PO BOX 129 200 E 8TH STREET
LARNED KS
67550-0129
US

V. Phone/Fax

Practice location:
  • Phone: 620-285-6424
  • Fax: 620-285-3660
Mailing address:
  • Phone: 620-285-6424
  • Fax: 620-285-3660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY ANN BLIDE
Title or Position: OFFICE ASSISTANT
Credential:
Phone: 620-285-6424