Provider Demographics
NPI:1861469561
Name:WPM PATHOLOGY LABORATORY CHARTERED
Entity type:Organization
Organization Name:WPM PATHOLOGY LABORATORY CHARTERED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-823-7201
Mailing Address - Street 1:338 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2027
Mailing Address - Country:US
Mailing Address - Phone:785-823-7201
Mailing Address - Fax:785-823-7185
Practice Address - Street 1:338 N FRONT ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-2027
Practice Address - Country:US
Practice Address - Phone:785-823-7201
Practice Address - Fax:785-823-7185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100095740AMedicaid