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NPI Code Detail

MEDICARE: COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.

MEDICARE: COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1468481OTHERCHILDRENS MERCY FHP
217-1821OTHERNGS NAT. GOV. SERVICES
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972794402
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Provider Business Mailing Address
First Line : 3011 N MICHIGAN ST
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-2546
Country : US
Telephone Number : 620-231-9873
Fax Number : 620-231-2808
Provider Business Practice Location Address
First Line : 101 W SYCAMORE ST
Second Line :
City : COLUMBUS
State : KS
Zip : 66725-1276
Country : US
Telephone Number : 620-249-2101
Fax Number : 620-429-2106
Authorized Official
Title or Position : CEO
Name : KRISTA K POSTAI
Credential :
Telephone Number : 620-231-9873
Provider Enumeration Date : 08/08/2007
Last Update Date : 01/03/2020

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