Healthcare Provider Details
I. General information
NPI: 1639642820
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF SOUTHEAST KANAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/10/2019
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2322 S MAIN ST
FORT SCOTT KS
66701-3026
US
IV. Provider business mailing address
3011 N MICHIGAN ST
PITTSBURG KS
66762-2546
US
V. Phone/Fax
- Phone: 620-223-7075
- Fax: 620-223-7050
- Phone: 620-231-9873
- Fax: 620-231-5062
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRISTA
POSTAI
Title or Position: CEO AND PRESIDENT
Credential:
Phone: 620-231-9873