Provider Demographics
NPI:1316043631
Name:VIA CHRISTI CLINIC, PA
Entity Type:Organization
Organization Name:VIA CHRISTI CLINIC, PA
Other - Org Name:VCC DAY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR,PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SUZAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-719-1201
Mailing Address - Street 1:PO BOX 8035
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0035
Mailing Address - Country:US
Mailing Address - Phone:316-689-9135
Mailing Address - Fax:316-689-9102
Practice Address - Street 1:3311 E MURDOCK ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3054
Practice Address - Country:US
Practice Address - Phone:316-689-9595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSCU0056OtherMEDICARE RAILROAD
KS400505OtherHPK
KSCC8849OtherMEDICARE RAILROAD
KS200726520GMedicaid
KS014307OtherBCBS
KS16690OtherCOVENTRY
KS1088OtherPHS
KSCC8848OtherMEDICARE RAILROAD
KS16690OtherCOVENTRY