1437131265 NPI number — DODGE CITY MEDICAL CENTER CHARTERED

Table of content: (NPI 1437131265)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437131265 NPI number — DODGE CITY MEDICAL CENTER CHARTERED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DODGE CITY MEDICAL CENTER CHARTERED
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:
DODGE CITY MEDICAL CENTER
Provider Other Organization Name Type Code:
5
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:
1437131265
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DODGE CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67801-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-227-1371
Provider Business Mailing Address Fax Number:
620-227-1208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2020 CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DODGE CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67801-6411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-227-1371
Provider Business Practice Location Address Fax Number:
620-227-1208
Provider Enumeration Date:
11/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FROETSCHNER
Authorized Official First Name:
NINA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADM ASSISTANT
Authorized Official Telephone Number:
620-227-1206

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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