Provider Demographics
NPI:1720271091
Name:ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC.
Entity Type:Organization
Organization Name:ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIR ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:COPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-776-2841
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:1823 COLLEGE AVE.
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66505-1289
Mailing Address - Country:US
Mailing Address - Phone:785-776-3322
Mailing Address - Fax:785-776-1988
Practice Address - Street 1:1823 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-776-3322
Practice Address - Fax:785-776-1988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-21
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100265560IMedicaid
KSH081003OtherHOSPITAL LICENSE #
KS100265560IMedicaid