Provider Demographics
NPI:1144241738
Name:ASCENSION VIA CHRISTI HOSPITAL PITTSBURG, INC.
Entity type:Organization
Organization Name:ASCENSION VIA CHRISTI HOSPITAL PITTSBURG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:CASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-232-0109
Mailing Address - Street 1:1 MT CARMEL WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-7587
Mailing Address - Country:US
Mailing Address - Phone:620-231-6100
Mailing Address - Fax:620-232-0493
Practice Address - Street 1:1 MT CARMEL WAY
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-7587
Practice Address - Country:US
Practice Address - Phone:620-231-6100
Practice Address - Fax:620-232-0493
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION VIA CHRISTI HOSPITAL PITTSBURG, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH019002314000000X
KSH-019-002314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100108220AMedicaid
KS175178Medicare Oscar/Certification