Healthcare Provider Details

I. General information

NPI: 1376539502
Provider Name (Legal Business Name): VIA CHRISTI HOSPITALS WICHITA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 04/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N EMPORIA ST SUITE E
WICHITA KS
67214-3707
US

IV. Provider business mailing address

PO BOX 1897
WICHITA KS
67201-1897
US

V. Phone/Fax

Practice location:
  • Phone: 316-858-3460
  • Fax: 316-858-3458
Mailing address:
  • Phone: 316-268-8131
  • Fax: 316-291-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. LAURIE A LABARCA
Title or Position: COO
Credential:
Phone: 316-268-5161