Provider Demographics
NPI:1346349008
Name:SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER
Other - Org Name:SOUTH CENTRAL KANSAS HOME CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-442-2500
Mailing Address - Street 1:PO BOX 1107
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-1107
Mailing Address - Country:US
Mailing Address - Phone:620-442-2500
Mailing Address - Fax:620-441-5953
Practice Address - Street 1:6401 PATTERSON PKWY
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-5701
Practice Address - Country:US
Practice Address - Phone:620-442-2500
Practice Address - Fax:620-441-5953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-018-002251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100080590FMedicaid
KS177138Medicare Oscar/Certification