Healthcare Provider Details

I. General information

NPI: 1972657468
Provider Name (Legal Business Name): ATTICA HOSPITAL DISTRICT #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 NORTH BOTKIN
ATTICA KS
67009-9032
US

IV. Provider business mailing address

302 NORTH BOTKIN
ATTICA KS
67009-9032
US

V. Phone/Fax

Practice location:
  • Phone: 620-254-7253
  • Fax: 620-254-7629
Mailing address:
  • Phone: 620-254-7253
  • Fax: 620-254-7629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberN039003
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANNON KUNZ
Title or Position: BOARD CHAIRMAN
Credential:
Phone: 620-254-7256