Healthcare Provider Details

I. General information

NPI: 1720271091
Provider Name (Legal Business Name): ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1823 COLLEGE AVE
MANHATTAN KS
66502
US

IV. Provider business mailing address

PO BOX 1289 1823 COLLEGE AVE.
MANHATTAN KS
66505-1289
US

V. Phone/Fax

Practice location:
  • Phone: 785-776-3322
  • Fax: 785-776-1988
Mailing address:
  • Phone: 785-776-3322
  • Fax: 785-776-1988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT COPPLE
Title or Position: SENIR ADMINISTRATOR
Credential:
Phone: 785-776-2841