Provider Demographics
NPI:1386955649
Name:RAUSCH MEDICAL CLINICS, LLC
Entity type:Organization
Organization Name:RAUSCH MEDICAL CLINICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-201-6711
Mailing Address - Street 1:1306 STATE ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-1126
Mailing Address - Country:US
Mailing Address - Phone:316-775-9191
Mailing Address - Fax:
Practice Address - Street 1:700 W CENTRAL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-2184
Practice Address - Country:US
Practice Address - Phone:316-320-9191
Practice Address - Fax:316-320-2220
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUGUSTA FAMILY PRACTICE, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-01
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200684990AMedicaid