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NPI Code Detail

MEDICARE: CENTRAL CARE PA

MEDICARE: CENTRAL CARE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology Physician
2207RX0202XMedical Oncology Physician
3332900000XNon-Pharmacy Dispensing Site0424425KS

General Provider Information

NPI Number : 1922340223
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL CARE PA
Provider Business Mailing Address
First Line : PO BOX 256
Second Line :
City : SALINA
State : KS
Zip : 67402-0256
Country : US
Telephone Number : 785-823-0633
Fax Number : 785-823-0658
Provider Business Practice Location Address
First Line : 204 CLEVELAND ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3563
Country : US
Telephone Number : 620-792-5511
Fax Number : 620-792-5977
Authorized Official
Title or Position : CREDENTIALING
Name : CANDICE EVANS
Credential :
Telephone Number : 620-603-8846
Provider Enumeration Date : 03/25/2013
Last Update Date : 04/02/2024

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Directions to “CENTRAL CARE PA ” Practice Location

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