Organization
COMMUNITY HEALTHCARE SYSTEM, INC
Active
Other names
Centralia Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD M WILLERT (CEO)
(785) 889-5002
Entity
Organization
Contact information
Practice address
606 1ST ST, CENTRALIA, KS 66415-9637
(785) 857-3334
(785) 857-3349
Mailing address
606 1ST ST, CENTRALIA, KS 66415-9637
(785) 857-3334
(785) 857-3349
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
H075001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001436
BLUE CROSS BLUE SHIELD
KS
05
—
100319940A
—
KS
Enumeration date
02/07/2006
Last updated
06/02/2020
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