Provider Demographics
NPI:1972794402
Name:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Other - Org Name:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS/COLUMBUS CLINIC
Other - Org Type:Doing Business As
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:620-231-2808
Practice Address - Street 1:101 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:KS
Practice Address - Zip Code:66725-1276
Practice Address - Country:US
Practice Address - Phone:620-249-2101
Practice Address - Fax:620-429-2106
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-08
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
468481OtherCHILDRENS MERCY FHP
17-1821OtherNGS NAT. GOV. SERVICES
KS100456320EMedicaid
OK200099190CMedicaid
KS100456320WMedicaid
KS100456320WMedicaid