Gracemed Evergreen Family Clinic

LBN: Gracemed Health Clinic, Inc
Gracemed Evergreen Family Clinic is an health care organization with primary practice located at 1125 W 26Th St N , Wichita KS 67204-5102. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Gracemed Health Clinic, Inc can be contacted via phone (316) 866-2000, or through Lee, Venus via phone (316) 866-2064.

Contact Information

Primary practice address
1125 W 26Th St N Wichita KS 67204-5102
Phone: (316) 866-2000
Fax: (316) 866-2084
Website:
Map and Directions
Authorized official contact:
Name: Lee, Venus
Phone: (316) 866-2064

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1912333774
LBN Legal business name Gracemed Health Clinic, Inc
DBA Doing business as Gracemed Evergreen Family Clinic
Authorized official Lee, Venus
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 24th, 2013
Last updated Feb 14th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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