Provider Demographics
NPI:1194068502
Name:SALINA REGIONAL HEALTH CENTER, INC.
Entity type:Organization
Organization Name:SALINA REGIONAL HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-452-6152
Mailing Address - Street 1:400 S SANTA FE AVE
Mailing Address - Street 2:SRHC REVENUE CYCLE MGMT
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4144
Mailing Address - Country:US
Mailing Address - Phone:785-452-7269
Mailing Address - Fax:785-452-6008
Practice Address - Street 1:400 S SANTA FE AVE
Practice Address - Street 2:DEPARTMENT OF REHAB MEDICINE
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4144
Practice Address - Country:US
Practice Address - Phone:785-452-7731
Practice Address - Fax:785-452-7811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALINA REGIONAL HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-03
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 133V00000X, 207Q00000X, 207R00000X, 208100000X, 208D00000X, 225100000X, 225X00000X, 235Z00000X
KS0430495208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100068090JMedicaid
KS100059160EMedicaid