PRAIRIESTAR HEALTH CENTER INC NPI 1871564534

NPI Information

NPI: 1871564534
Provider Name: PRAIRIESTAR HEALTH CENTER, INC

Former Legal Business Name: COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
2700 E 30TH AVE
HUTCHINSON, KS
ZIP 67502
Phone: (620) 663-8484
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PRAIRIESTAR HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Hutchinson, KS. PRAIRIESTAR HEALTH CENTER, INC NPI is 1871564534. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Community Health Center.

The provider's business location address is:

2700 E 30TH AVE
HUTCHINSON, KS
ZIP 67502
Phone: (620) 663-8484
Fax: (620) 802-0690

The provider's authorized official is Justin Bryant Anderson .
The authorized official title is Chief Executive Officer and has the following contact phone number (620) 663-8484.

The CLIA number assigned to this NPI record is 17D0900017 - federally qualified health center with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 1/31/2006 and was last updated on 7/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		KANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110056	OTHER		KANSAS BLUE CROSS BS
2	100175060B	MEDICAID	KANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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