Provider Demographics
NPI:1568979557
Name:SOUTHWEST MEDICAL CENTER
Entity Type:Organization
Organization Name:SOUTHWEST MEDICAL CENTER
Other - Org Name:SOUTHWEST MEDICAL CENTER ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-629-6892
Mailing Address - Street 1:PO BOX 1340
Mailing Address - Street 2:
Mailing Address - City:LIBERAL
Mailing Address - State:KS
Mailing Address - Zip Code:67905-1340
Mailing Address - Country:US
Mailing Address - Phone:620-629-6682
Mailing Address - Fax:620-629-6683
Practice Address - Street 1:315 W 15TH ST
Practice Address - Street 2:
Practice Address - City:LIBERAL
Practice Address - State:KS
Practice Address - Zip Code:67901-2455
Practice Address - Country:US
Practice Address - Phone:620-629-6682
Practice Address - Fax:620-629-6683
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENERAL ACUTE CARE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty