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General NPI Number Information
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NPI Number | 1619812724
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Entity Type | Organization
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Legal Business Name | GRACEMED HEALTH CLINIC, INC
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 814 S WOODLAWN BLVD
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City | WICHITA
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State | KS
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Zip | 67218-2846
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Country | US
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Telephone | 316-866-2000
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Fax | 316-866-2084
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Provider Business Mailing Address
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Address Line | 1150 N BROADWAY AVE
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City | WICHITA
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State | KS
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Zip | 67214-2805
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Country | US
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Telephone | 316-866-2000
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Fax | 316-866-2084
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Authorized Official
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Title or Position | CEO
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Name | JULIE ELDER
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Credential | DO
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Telephone | 316-866-2000
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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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