1720005598 NPI number — WILLIAM NEWTON MEMORIAL HOSPITAL

Table of content: (NPI 1720005598)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720005598 NPI number — WILLIAM NEWTON MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM NEWTON MEMORIAL HOSPITAL
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:
TALLGRASS RURAL HEALTH CLINIC
Provider Other Organization Name Type Code:
3
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:
1720005598
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 308
Provider Second Line Business Mailing Address:
300 NORTH STREET
Provider Business Mailing Address City Name:
SEDAN
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67361-0308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-725-3818
Provider Business Mailing Address Fax Number:
620-725-5433

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 W NORTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEDAN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67361-1051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-725-3818
Provider Business Practice Location Address Fax Number:
620-725-5433
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
METZINGER
Authorized Official First Name:
JOSHUA
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINIC MANAGER
Authorized Official Telephone Number:
620-758-2221

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , with the licence number:  173423 , 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: 100005090E , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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