MEDICARE: SCOTT COUNTY HOSPITAL, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000557	OTHER	KS	BCBS HH #
2	000557	OTHER	KS	BCBS
3	000557	OTHER	KS	BCBS OF KS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447280078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT COUNTY HOSPITAL, INC

Provider Business Mailing Address
First Line	:	110 E. 4TH STR.
Second Line	:
City	:	SCOTT CITY
State	:	KS
Zip	:	67871
Country	:	US
Telephone Number	:	620-874-4868
Fax Number	:	620-872-5014

Provider Business Practice Location Address
First Line	:	110 E 4TH ST
Second Line	:
City	:	SCOTT CITY
State	:	KS
Zip	:	67871-1254
Country	:	US
Telephone Number	:	620-874-4868
Fax Number	:	620-872-5014

Authorized Official
Title or Position	:	CEO
Name	:	MR. D MARK BURNETT
Credential	:
Telephone Number	:	620-872-5811

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	10/23/2014

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