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General NPI Number Information
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NPI Number | 1881245108
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
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Dates
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Enumeration Date | 09/27/2019
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 11155 TUCKER RD
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City | PLEASANTON
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State | KS
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Zip | 66075-8401
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Country | US
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Telephone | 913-347-8110
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Fax | 918-347-8115
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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 | 620-231-9873
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Fax | 620-231-5062
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | KRISTA K POSTAI
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Credential |
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Telephone | 620-231-9873
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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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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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