Organization
CENTERWELL SENIOR PRIMARY CARE KS PA
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE KS PA
Other names
CenterWell Senior Primary Care (KS) PA - Parklane
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE KS PA
Authorized official
MEGAN GALVAN (CREDENTIALING MANAGER)
(305) 500-2000
Entity
Organization
Contact information
Practice address
961 S GLENDALE ST, WICHITA, KS 67218-3210
(316) 618-9555
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
10/10/2024
Last updated
05/30/2025
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