St Rose Healthcare Center LLC
NPI #1760885008 in Great Bend, Kansas
Provider Information
- NPI Number
- 1760885008
- Entity Type
- Organization
- Organization Name
- St Rose Healthcare Center LLC
- Primary Specialty
- Physiological Laboratory
- Enumeration Date
- Oct 1, 2014
- Last Updated
- Oct 1, 2014
Practice Location
- Address
- 3515 BROADWAY AVE
- City
- Great Bend
- State
- Kansas
- ZIP Code
- 67530-3633
- Phone
- (620) 792-2511
Authorized Official
- Name
- DR. JOHN H JETER, M.D.
- Title
- PRESIDENT & CEO
- Phone
- (785) 623-5523
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physiological Laboratory |
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