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General NPI Number Information
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NPI Number | 1336969500
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTER IN COWLEY COUNTY INC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 600 S B ST
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City | ARKANSAS CITY
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State | KS
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Zip | 67005-3469
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Country | US
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Telephone | 620-221-3350
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Fax | 620-221-6061
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Provider Business Mailing Address
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Address Line | 118 W 9TH AVE
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City | WINFIELD
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State | KS
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Zip | 67156-2852
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Country | US
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Telephone | 620-221-3350
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Fax | 620-221-6061
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Authorized Official
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Title or Position | CEO
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Name | DAVID EDWARD BRAZIL
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Credential |
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Telephone | 620-221-3350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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