Provider Demographics
NPI:1548235120
Name:CENTRAL KANSAS ENT ASSOCIATES,PA
Entity Type:Organization
Organization Name:CENTRAL KANSAS ENT ASSOCIATES,PA
Other - Org Name:HEARTLAND SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OF ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-823-7225
Mailing Address - Street 1:520 S SANTA FE AVE
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4190
Mailing Address - Country:US
Mailing Address - Phone:785-823-7225
Mailing Address - Fax:785-823-1017
Practice Address - Street 1:520 S SANTA FE AVE
Practice Address - Street 2:SUITE 200A
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4190
Practice Address - Country:US
Practice Address - Phone:785-823-7225
Practice Address - Fax:785-823-1017
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL KANSAS ENT ASSOCIATES,PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-17
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSS085002261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200317920AMedicaid
KS200317920AMedicaid