1114964111 NPI number — THE CLARA BARTON HOSPITAL ASSOCIATION, INC. HOISINGTON KANSAS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114964111 NPI number — THE CLARA BARTON HOSPITAL ASSOCIATION, INC. HOISINGTON KANSAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CLARA BARTON HOSPITAL ASSOCIATION, INC. HOISINGTON KANSAS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114964111
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 W 9TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOISINGTON
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67544-1706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-653-2114
Provider Business Mailing Address Fax Number:
620-653-2350

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 W 9TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOISINGTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67544-1706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-653-2114
Provider Business Practice Location Address Fax Number:
620-653-2350
Provider Enumeration Date:
05/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TUSTEN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
620-653-2114

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  H005003 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30003913800004 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001608 . This is a "BCBS SWING BED" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 30003913800008 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: CB3501 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000112 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 016491 . This is a "BSBS MD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100099000A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010267 . This is a "BCBS DME" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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