Provider Demographics
NPI:1457757346
Name:SOUTH WIND WOMEN'S CENTTER, LLC
Entity Type:Organization
Organization Name:SOUTH WIND WOMEN'S CENTTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-260-6934
Mailing Address - Street 1:5701 E KELLOGG DRIVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218
Mailing Address - Country:US
Mailing Address - Phone:316-425-3215
Mailing Address - Fax:316-215-6516
Practice Address - Street 1:5701 E KELLOGG DRIVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218
Practice Address - Country:US
Practice Address - Phone:316-425-3215
Practice Address - Fax:316-215-6516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSS-087-025261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical