Healthcare Provider Details

I. General information

NPI: 1245369511
Provider Name (Legal Business Name): MITCHELL COUNTY HOSPITAL HEALTH SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 WEST 8TH ST
BELOIT KS
67420
US

IV. Provider business mailing address

PO BOX 399
BELOIT KS
67420-0399
US

V. Phone/Fax

Practice location:
  • Phone: 785-738-2266
  • Fax: 785-738-9503
Mailing address:
  • Phone: 785-738-2266
  • Fax: 785-738-9503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. ELDON KOEPKE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 785-738-2266