Healthcare Provider Details

I. General information

NPI: 1568094662
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2020
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W SYCAMORE ST
COLUMBUS KS
66725-1276
US

IV. Provider business mailing address

3011 N MICHIGAN ST
PITTSBURG KS
66762-2546
US

V. Phone/Fax

Practice location:
  • Phone: 620-249-2101
  • Fax: 620-429-2106
Mailing address:
  • Phone: 620-231-9873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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