Healthcare Provider Details

I. General information

NPI: 1871823344
Provider Name (Legal Business Name): CAH ACQUISITION COMPANY 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BARKER DR STE B
OSWEGO KS
67356
US

IV. Provider business mailing address

800 BARKER DR SUITE B
OSWEGO KS
67356-9033
US

V. Phone/Fax

Practice location:
  • Phone: 620-795-2119
  • Fax: 620-795-2357
Mailing address:
  • Phone: 620-795-2119
  • Fax: 620-795-2357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberH050003
License Number StateKS

VIII. Authorized Official

Name: BILLY D COCHRAN
Title or Position: CEO
Credential:
Phone: 620-795-2921