Provider Demographics
NPI:1659367886
Name:VIA CHRISTI REGIONAL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:VIA CHRISTI REGIONAL MEDICAL CENTER INC
Other - Org Name:VCRMC ACUTE AND CRITICAL CARE NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LABARCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-268-5161
Mailing Address - Street 1:PO BOX 1087
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1087
Mailing Address - Country:US
Mailing Address - Phone:316-268-8131
Mailing Address - Fax:316-291-4788
Practice Address - Street 1:929 N SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3821
Practice Address - Country:US
Practice Address - Phone:316-268-7085
Practice Address - Fax:316-291-4862
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIA CHRISTI REGIONAL MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-22
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100080640KMedicaid
KS100080640KMedicaid