Provider Demographics
NPI:1568843050
Name:COMMUNITY HEALTH CENTER IN COWLEY COUNTY INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CENTER IN COWLEY COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRAZIL
Authorized Official - Suffix:
Authorized Official - Credentials:RS
Authorized Official - Phone:620-229-0434
Mailing Address - Street 1:221 W 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-2718
Mailing Address - Country:US
Mailing Address - Phone:620-221-3350
Mailing Address - Fax:620-221-6061
Practice Address - Street 1:221 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-2718
Practice Address - Country:US
Practice Address - Phone:620-221-3350
Practice Address - Fax:620-221-6061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)