Provider Demographics
NPI:1104904267
Name:OUR FAMILY CARE CENTER LLC
Entity type:Organization
Organization Name:OUR FAMILY CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:SWEARENGIN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:620-784-5784
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:ALTAMONT
Mailing Address - State:KS
Mailing Address - Zip Code:67330-0248
Mailing Address - Country:US
Mailing Address - Phone:620-784-5784
Mailing Address - Fax:620-784-5301
Practice Address - Street 1:401 S WABASH
Practice Address - Street 2:
Practice Address - City:ALTAMONT
Practice Address - State:KS
Practice Address - Zip Code:67330-0248
Practice Address - Country:US
Practice Address - Phone:620-784-5784
Practice Address - Fax:620-784-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110985Medicare ID - Type Unspecified