Provider Demographics
NPI:1669474425
Name:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:K
Authorized Official - Last Name:POSTAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-231-9873
Mailing Address - Street 1:3011 N MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-2546
Mailing Address - Country:US
Mailing Address - Phone:620-231-9873
Mailing Address - Fax:
Practice Address - Street 1:3011 N MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-2546
Practice Address - Country:US
Practice Address - Phone:620-231-9873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
463501OtherCHILDRENS MERCY FHP
MO506100304Medicaid
KS100456320AMedicaid
KS110931OtherBLUE CROSS BLUE SHIELD
OK200099190DMedicaid
17-1820OtherNGS
KS100456320AMedicaid