Organization
HOLY FAMILY MEDICAL, INC.
Active
Parent organization
HOLY FAMILY MEDICAL INC.
Other names
Holy Family Fairmount
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOLY FAMILY MEDICAL INC.
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) 682-9900
Mailing address
144 S. HILLSIDE ST., WICHITA, KS 67211, WICHITA, KS, KS 67211
(316) 682-9900
(316) 682-0311
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KS
Enumeration date
09/16/2022
Last updated
09/16/2022
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