GRACEMED HEALTH CLINIC, INC; NPI #1053770818

Contact Information

GRACEMED HEALTH CLINIC, INC

3417 S MERIDIAN AVE
WICHITA, KS 67217-2151

Phone: 316-866-2000
Fax: 316-866-2084
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for GRACEMED HEALTH CLINIC, INC

NPI Number	`1053770818`
LBN Legal business name	GRACEMED HEALTH CLINIC, INC
Authorized official	JULIE ELDER - (CEO)
Entity	Organization
Organization subpart ¹	No
Enumeration date	02/22/2016
Last updated	09/08/2025 - About 9 months ago
Identifiers	n/a

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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