Provider Demographics
NPI:1770180457
Name:SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER
Other - Org Name:SCKMC PROFESSIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-441-5798
Mailing Address - Street 1:6401 PATTERSON PKWY
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-5701
Mailing Address - Country:US
Mailing Address - Phone:620-442-2500
Mailing Address - Fax:
Practice Address - Street 1:6401 PATTERSON PKWY
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-5701
Practice Address - Country:US
Practice Address - Phone:620-442-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty