Healthcare Provider Details

I. General information

NPI: 1720099039
Provider Name (Legal Business Name): ASCENSION VIA CHRISTI IMAGING WICHITA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2734 N WOODLAWN ST
WICHITA KS
67220-2730
US

IV. Provider business mailing address

PO BOX 47121
WICHITA KS
67201-7121
US

V. Phone/Fax

Practice location:
  • Phone: 316-946-5080
  • Fax: 316-946-5088
Mailing address:
  • Phone: 316-858-4091
  • Fax: 316-369-1167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
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