Healthcare Provider Details

I. General information

NPI: 1336269638
Provider Name (Legal Business Name): SUMNER COUNTY FAMILY CARE CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E MAIN ST
MULVANE KS
67110-1751
US

IV. Provider business mailing address

102 E MAIN ST
MULVANE KS
67110-1751
US

V. Phone/Fax

Practice location:
  • Phone: 316-777-0106
  • Fax: 316-777-4300
Mailing address:
  • Phone: 316-777-0106
  • Fax: 316-777-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMBER DAWSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 620-326-3301