1952593915 NPI number — ASCENSION MEDICAL GROUP VIA CHRISTI, PA

Table of content: (NPI 1184977811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952593915 NPI number — ASCENSION MEDICAL GROUP VIA CHRISTI, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASCENSION MEDICAL GROUP VIA CHRISTI, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASCENSION VIA CHRISTI SLEEP CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952593915
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
750 N SOCORA ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67212-3793
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-946-1790
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 N SOCORA ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67212-3793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-946-1790
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
SUZANN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR,PATIENT FINANCIAL SERVICES
Authorized Official Telephone Number:
316-719-1201

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10051 . This is a "PHS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 500073 . This is a "HPK" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 118032 . This is a "BCBS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".