Provider Demographics
NPI:1508109299
Name:SALINA REGIONAL HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:SALINA REGIONAL HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-452-6152
Mailing Address - Street 1:400 S SANTA FE AVE
Mailing Address - Street 2:SRHC REVENUE CYCLE
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4144
Mailing Address - Country:US
Mailing Address - Phone:785-452-7269
Mailing Address - Fax:785-452-6008
Practice Address - Street 1:2090 S OHIO ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-6702
Practice Address - Country:US
Practice Address - Phone:785-825-8221
Practice Address - Fax:785-452-7530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALINA REGIONAL HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-01
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X, 207R00000X
KS207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100059160FMedicaid
KS110116Medicare PIN