Healthcare Provider Details

I. General information

NPI: 1669471710
Provider Name (Legal Business Name): ASCENSION VIA CHRISTI IMAGING MANHATTAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 COLLEGE AVE BLDG G SUITE 110
MANHATTAN KS
66502-2770
US

IV. Provider business mailing address

PO BOX 1329
MANHATTAN KS
66505
US

V. Phone/Fax

Practice location:
  • Phone: 785-776-3322
  • Fax: 785-532-9036
Mailing address:
  • Phone: 785-776-3322
  • Fax: 785-776-1988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License NumberH081003
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberH081003
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License NumberH081003
License Number StateKS

VIII. Authorized Official

Name: MRS. CARLA YOST
Title or Position: CNO
Credential:
Phone: 913-904-6907