Provider Demographics
NPI:1265633259
Name:EMPAC INC
Entity Type:Organization
Organization Name:EMPAC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:316-265-9922
Mailing Address - Street 1:300 W DOUGLAS AVE
Mailing Address - Street 2:SUITE 930
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-2916
Mailing Address - Country:US
Mailing Address - Phone:316-265-9922
Mailing Address - Fax:316-265-9427
Practice Address - Street 1:300 W DOUGLAS AVE
Practice Address - Street 2:SUITE 930
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2916
Practice Address - Country:US
Practice Address - Phone:316-265-9922
Practice Address - Fax:316-265-9427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health