Healthcare Provider Details

I. General information

NPI: 1942647151
Provider Name (Legal Business Name): MIDWEST FAMILY HEALTH OF PLAINVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W MILL ST
PLAINVILLE KS
67663-2227
US

IV. Provider business mailing address

PO BOX 608
PHILLIPSBURG KS
67661-0608
US

V. Phone/Fax

Practice location:
  • Phone: 785-434-4615
  • Fax: 785-434-4895
Mailing address:
  • Phone: 785-434-4615
  • Fax: 785-434-4895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STACIE RICKER
Title or Position: OWNER
Credential:
Phone: 785-540-4143