Healthcare Provider Details

I. General information

NPI: 1649557281
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W 8TH ST
COFFEYVILLE KS
67337-4109
US

IV. Provider business mailing address

3011 N MICHIGAN ST
PITTSBURG KS
66762-2546
US

V. Phone/Fax

Practice location:
  • Phone: 620-251-4300
  • Fax: 620-251-4979
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