Healthcare Provider Details

I. General information

NPI: 1790165207
Provider Name (Legal Business Name): ASCENSION VIA CHRISTI IMAGING WICHITA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 N SAINT FRANCIS ST
WICHITA KS
67214-3822
US

IV. Provider business mailing address

PO BOX 47121
WICHITA KS
67201-7121
US

V. Phone/Fax

Practice location:
  • Phone: 316-268-6782
  • Fax: 316-291-7969
Mailing address:
  • Phone: 316-268-6782
  • Fax: 316-291-7969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateKS

VIII. Authorized Official

Name: MR. CLAUDIO J FERRARO
Title or Position: ADMINISTRATOR
Credential:
Phone: 316-268-8026