Healthcare Provider Details

I. General information

NPI: 1932414224
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 MILITARY AVE
BAXTER SPRINGS KS
66713-2331
US

IV. Provider business mailing address

PO BOX 1832
PITTSBURG KS
66762-1832
US

V. Phone/Fax

Practice location:
  • Phone: 620-856-2900
  • Fax: 620-856-2901
Mailing address:
  • Phone: 620-231-9873
  • Fax: 620-231-2808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: KRISTA K POSTAI
Title or Position: CEO
Credential:
Phone: 620-231-9873