National Provider Identifier Database

PRAIRIE BAND POTAWATOMI NATION
Federally Qualified Health Center (FQHC)

A Federally Qualified Health Center (FQHC) is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.


Contact Information

PRAIRIE BAND POTAWATOMI NATION
11400 158TH RD
MAYETTA, KS66509-0249
Phone: 785-966-8200
Fax: 785-966-8393
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X
Health Service 261QH0100X

* Indicates primary specialty

NPI Profile & details for PRAIRIE BAND POTAWATOMI NATION

NPI Number 1245266410
Legal business name
LBN
PRAIRIE BAND POTAWATOMI NATION
Authorized official TIFFANY LEWIS - (BUSINESS OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 06/22/2006
Last updated 07/21/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • KS Medicaid: 200259300A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for PRAIRIE BAND POTAWATOMI NATION

There are currently no reviews for PRAIRIE BAND POTAWATOMI NATION


NPIdb - Home
v2.201