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Contact Information

HEALTHCORE CLINIC INC
2707 EAST 21ST STREET NORTH
WICHITA, KS67214-2249
 Phone: 316-691-0249
 Fax: 316-691-9939
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
 

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
 

Rehabilitation, Substance Use Disorder

261QR0405X
Indicates primary specialty

NPI Profile & details for HEALTHCORE CLINIC INC

NPI # 1033218565
LBN Legal business name HEALTHCORE CLINIC INC
Authorized official TERESA LOVELADY - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 09/21/2006
Last updated 08/14/2015 - About 11 years ago
Identifiers
KS License # 07000882
KS License # 07000887
KS License # 1033218565
KS Medicaid 100321990
KS Medicaid 100321990A
KS Medicaid 100321990C
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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