Provider Demographics
NPI:1265891048
Name:ASCENSION VIA CHRISTI IMAGING WICHITA, LLC
Entity type:Organization
Organization Name:ASCENSION VIA CHRISTI IMAGING WICHITA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAUDIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:FERRARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-268-8026
Mailing Address - Street 1:PO BOX 47121
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-7121
Mailing Address - Country:US
Mailing Address - Phone:316-269-1738
Mailing Address - Fax:316-269-1759
Practice Address - Street 1:825 N EMPORIA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3709
Practice Address - Country:US
Practice Address - Phone:316-269-1738
Practice Address - Fax:316-269-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS470001645OtherRAILROAD MEDICARE
KSKA3969Medicare PIN