Organization
SOUTHWEST MEDICAL CENTER
Active
Parent organization
SOUTHWEST MEDICAL CENTER
Other names
Southwest Medical Center Psychiatric Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST MEDICAL CENTER
Authorized official
MR. DELANY FAWKES (CFO/VP OF FINANCE)
(620) 629-6300
Entity
Organization
Contact information
Practice address
315 W 15TH STREET, LIBERAL, KS 67901-2455
(620) 624-1651
(620) 629-2474
Mailing address
315 W 15TH STREET, PO BOX 1340, LIBERAL, KS 67905-1340
(620) 624-1651
(620) 629-2472
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000812
BLUE CROSS BLUE SHIELD
KS
Enumeration date
06/15/2006
Last updated
09/15/2009
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