Organization
CENTRAL CARE, PA
Active
Parent organization
CENTRAL CARE, PA
Other names
Central Care Cancer Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL CARE, PA
Authorized official
STACY CLOYD (CREDENTIALING MANAGER)
(785) 823-0633
Entity
Organization
Contact information
Practice address
9300 E 29TH ST N, STE 315, WICHITA, KS 67226-2182
(316) 771-5896
(316) 201-3055
Mailing address
PO BOX 256, SALINA, KS 67402-0256
(785) 823-0633
(844) 854-4662
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100143020C
—
KS
05
—
200480600F
—
OK
Enumeration date
03/15/2012
Last updated
04/20/2017
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