Provider Demographics
NPI:1912993148
Name:VIA CHRISTI REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:VIA CHRISTI REGIONAL MEDICAL CENTER
Other - Org Name:PHYSICIAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO VCRMC
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHUMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-268-5108
Mailing Address - Street 1:PO BOX 48542
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-8542
Mailing Address - Country:US
Mailing Address - Phone:316-681-3425
Mailing Address - Fax:316-681-3554
Practice Address - Street 1:929 N SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3821
Practice Address - Country:US
Practice Address - Phone:316-268-5794
Practice Address - Fax:316-291-7921
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIA CHRISTI REGIONAL MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-22
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110679Medicare ID - Type Unspecified