# COFFEYVILLE REGIONAL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COFFEYVILLE REGIONAL MEDICAL CENTER INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1053862805
- **Legal business name:** COFFEYVILLE REGIONAL MEDICAL CENTER INC
- **Authorized official:** BRIAN H LAWRENCE (CEO)
- **Authorized official phone:** (620) 251-1200

## Contact information

- **Practice address:** 1400 W 4TH ST, STE 100, COFFEYVILLE, KS 67337-3306
- **Practice address phone:** (620) 688-6566
- **Mailing address:** 1400 W 4TH ST, COFFEYVILLE, KS 67337-3306
- **Mailing address phone:** (620) 251-1200
- **Mailing address fax:** (620) 252-1562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/17/2016
- **Last updated:** 03/17/2023