# CENTRAL KANSAS MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Joseph Family Medicine - Great Bend
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801042353
- **Authorized official:** LEANNE IRSIK (SR. VP/SITE ADMINISTRATOR)
- **Authorized official phone:** (620) 786-6163

## Contact information

- **Practice address:** 3520 LAKIN AVE, SUITE 103, GREAT BEND, KS 67530-3646
- **Practice address phone:** (620) 792-3345
- **Practice address fax:** (620) 792-3767
- **Mailing address:** 3520 LAKIN AVE, SUITE 103, GREAT BEND, KS 67530-3646
- **Mailing address phone:** (620) 792-3767
- **Mailing address fax:** (620) 792-3767

## Taxonomy

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

## Other

- **Enumeration date:** 08/15/2008
- **Last updated:** 11/27/2012