Organization
HOLY FAMILY MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA THANEL (CEO)
(316) 682-9900
Entity
Organization
Contact information
Practice address
144 S HILLSIDE ST, WICHITA, KS 67211-2154
(316) 682-9900
(316) 682-0311
Mailing address
144 S HILLSIDE ST, WICHITA, KS 67211-2154
(316) 682-9900
(316) 682-0311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/15/2019
Last updated
06/10/2021
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