Provider Demographics
NPI:1578201034
Name:UNITED METHODIST WESTERN KANSAS MEXICAN-AMERICAN MINISTRIES, INC.
Entity Type:Organization
Organization Name:UNITED METHODIST WESTERN KANSAS MEXICAN-AMERICAN MINISTRIES, INC.
Other - Org Name:GENESIS FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:620-271-7400
Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-0766
Mailing Address - Country:US
Mailing Address - Phone:620-271-7400
Mailing Address - Fax:
Practice Address - Street 1:100 W ROSS BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-7217
Practice Address - Country:US
Practice Address - Phone:620-227-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)