Provider Demographics
NPI:1730413196
Name:VIA CHRISTI REGIONAL MEDICAL CENTER INC
Entity type:Organization
Organization Name:VIA CHRISTI REGIONAL MEDICAL CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT VCRMC & CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHALENE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-268-5108
Mailing Address - Street 1:PO BOX 1897
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1897
Mailing Address - Country:US
Mailing Address - Phone:316-268-8131
Mailing Address - Fax:316-291-4788
Practice Address - Street 1:707 N EMPORIA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3707
Practice Address - Country:US
Practice Address - Phone:316-858-3470
Practice Address - Fax:316-291-4788
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIA CHRISTI REGIONAL MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100080640DMedicaid
KS100080640DMedicaid