Healthcare Provider Details

I. General information

NPI: 1538773569
Provider Name (Legal Business Name): ASCENSION MEDICAL GROUP VIA CHRISTI, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 E 16TH ST STE 1
WELLINGTON KS
67152-2828
US

IV. Provider business mailing address

507 E 16TH ST STE 1
WELLINGTON KS
67152-2828
US

V. Phone/Fax

Practice location:
  • Phone: 620-326-3301
  • Fax: 620-326-7086
Mailing address:
  • Phone: 620-326-3301
  • Fax: 620-326-7086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUZANN WRIGHT
Title or Position: DIRECTOR, PATIENT FINANCIAL SERVICE
Credential:
Phone: 316-719-1201