Healthcare Provider Details

I. General information

NPI: 1447598511
Provider Name (Legal Business Name): MAYFLOWER CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2013
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E 1ST ST
WICHITA KS
67202-2501
US

IV. Provider business mailing address

401 E 1ST ST
WICHITA KS
67202-2501
US

V. Phone/Fax

Practice location:
  • Phone: 316-558-3991
  • Fax: 316-558-3992
Mailing address:
  • Phone: 316-558-3991
  • Fax: 316-558-3992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA FRENCH
Title or Position: CEO
Credential:
Phone: 316-259-5927