Organization
PRAIRIESTAR HEALTH CENTER, INC
Active
Other names
Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN BRYANT ANDERSON (CHIEF EXECUTIVE OFFICER)
(620) 663-8484
Entity
Organization
Contact information
Practice address
2700 E 30TH AVE, HUTCHINSON, KS 67502
(620) 663-8484
(620) 663-9526
Mailing address
2700 E 30TH AVE, HUTCHINSON, KS 67502-1242
(620) 663-8484
(620) 802-0690
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100175060B
—
KS
01
—
110056
KANSAS BLUE CROSS BS
—
Enumeration date
01/31/2006
Last updated
03/15/2025
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