Provider Demographics
NPI:1598001331
Name:VIA CHRISTI REHABILITATION HOSPITAL, INC
Entity Type:Organization
Organization Name:VIA CHRISTI REHABILITATION HOSPITAL, INC
Other - Org Name:VIA CHRISTI OCCUPATIONAL & ENVIRONMENTAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFLEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-634-3400
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1258
Mailing Address - Country:US
Mailing Address - Phone:316-719-3158
Mailing Address - Fax:316-719-3195
Practice Address - Street 1:2535 E LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-3821
Practice Address - Country:US
Practice Address - Phone:316-687-9794
Practice Address - Fax:316-689-6957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
111008OtherMEDICARE PTAN