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General NPI Number Information
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NPI Number | 1144007030
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTER OF SOUTHEAST KANAS, INC.
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 801 W 8TH ST
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City | COFFEYVILLE
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State | KS
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Zip | 67337-4109
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Country | US
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Telephone | 620-505-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 3011 N MICHIGAN ST
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City | PITTSBURG
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State | KS
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Zip | 66762-2546
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Country | US
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Telephone | 620-240-5625
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Fax |
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Authorized Official
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Title or Position | SENIOR VP, CHIEF COMPLIANCE OFFICER
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Name | DANIEL SPENCER CREITZ
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Credential |
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Telephone | 620-240-5015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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