Organization
CENTRAL KANSAS MEDICAL CENTER
Active
Parent organization
CENTRAL KANSAS MEDICAL CENTER DBA ST. ROSE AMBULATORY & SURGERY CENTER
Other names
St Rose Anesthesia Pathology Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL KANSAS MEDICAL CENTER DBA ST. ROSE AMBULATORY & SURGERY CENTER
Authorized official
AMANDA VAUGHAN (CFO)
(620) 272-2222
Entity
Organization
Contact information
Practice address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 792-2511
Mailing address
PO BOX 388, NEWTON, KS 67114-0388
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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