| Holy Family Medical Inc | |
|
144 S Hillside St Wichita KS 67211-2154 | |
| (316) 682-9900 | |
| (316) 682-0311 |
| Full Name | Holy Family Medical Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 144 S Hillside St, Wichita, Kansas |
| Authorized Official Name and Position | Brenda Thanel (CEO) |
| Authorized Official Contact | 3166829900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holy Family Medical Inc 144 S Hillside St Wichita KS 67211-2154 Ph: (316) 682-9900 | Holy Family Medical Inc 144 S Hillside St Wichita KS 67211-2154 Ph: (316) 682-9900 |
| NPI Number | 1215593249 |
|---|---|
| Provider Enumeration Date | 05/15/2019 |
| Last Update Date | 06/10/2021 |
| Medicare PECOS PAC ID | 1658608906 |
|---|---|
| Medicare Enrollment ID | O20190808002052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215593249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Ronald C Ferris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831165562 PECOS PAC ID: 9537123971 Enrollment ID: I20041116000701 |
| Provider Name | Sophia M Zinkovsky |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891751269 PECOS PAC ID: 9537190368 Enrollment ID: I20050822001108 |
| Provider Name | Cheriana Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952801201 PECOS PAC ID: 6103187158 Enrollment ID: I20180307002771 |
| Provider Name | Samantha M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972003184 PECOS PAC ID: 6305108788 Enrollment ID: I20180323000025 |
| Provider Name | Diana C Oltean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124596887 PECOS PAC ID: 1658617790 Enrollment ID: I20190122001261 |
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