1225278328 NPI number — HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY

Table of content: (NPI 1225278328)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225278328 NPI number — HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY
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:
6
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:
1225278328
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
302 N HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GIRARD
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66743-2000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-724-8291
Provider Business Mailing Address Fax Number:
620-724-6332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 NW HIGHWAY 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHEROKEE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-457-8101
Provider Business Practice Location Address Fax Number:
620-457-8103
Provider Enumeration Date:
03/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
PAYNE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
620-724-8291

Provider Taxonomy Codes

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

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

  • Identifier: 100004200I , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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