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Ukhs Great Bend, LLC

Organization Active NPI General Practice Physician · Great Bend, KS

NPI 1992272918 · NPPES record last updated Mar 11, 2020

Key facts

NPI
1992272918
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
UKHS GREAT BEND, LLC
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(620) 786-6163
Fax
(620) 786-6298
NPI assigned
Oct 29, 2018
Organization subpart
No

Authorized official

Name
Jesse Mock
Title
Ceo
Phone
(620) 791-6272

Corporate family (same tax ID) 10

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Ukhs Great Bend LLC (11 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208D00000X Yes
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 786-6163

Other names

  • UKHS Great Bend St. Rose Pavilion Doing business as
  • UKHS St. Rose Health Center Doing business as

Other providers in Great Bend, KS

All providers in Great Bend, KS · General Practice Physician in Kansas

Sources for this page

Verify at the official NPI Registry.