| Community Health Center Of Southeast Kansas, Inc | |
|
924 N Broadway St Pittsburg KS 66762-3910 | |
| (620) 670-8070 | |
| Not Available |
| Full Name | Community Health Center Of Southeast Kansas, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 924 N Broadway St, Pittsburg, Kansas |
| Authorized Official Name and Position | Daniel Spencer Creitz (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 6202405015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Southeast Kansas, Inc Po Box 1832 Pittsburg KS 66762-1832 Ph: () - | Community Health Center Of Southeast Kansas, Inc 924 N Broadway St Pittsburg KS 66762-3910 Ph: (620) 670-8070 |
| NPI Number | 1174525943 |
|---|---|
| Provider Enumeration Date | 08/11/2005 |
| Last Update Date | 07/22/2024 |
| Medicare PECOS PAC ID | 7911816392 |
|---|---|
| Medicare Enrollment ID | O20140314000180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174525943 | NPI | - | NPPES |
| 30003958250013 | Medicaid | KS | |
| 171851 | Other | KS | MEDICARE |
| 200099190A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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