Provider Demographics
NPI:1992543466
Name:ATCHISON COMMUNITY HEALTH CLINIC INC
Entity type:Organization
Organization Name:ATCHISON COMMUNITY HEALTH CLINIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:OOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-367-4879
Mailing Address - Street 1:3164 SE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66607-2204
Mailing Address - Country:US
Mailing Address - Phone:785-233-5116
Mailing Address - Fax:785-233-2800
Practice Address - Street 1:3164 SE 6TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66607-2204
Practice Address - Country:US
Practice Address - Phone:785-233-5116
Practice Address - Fax:785-233-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No122300000XDental ProvidersDentistGroup - Single Specialty