Healthcare Provider Details

I. General information

NPI: 1508941865
Provider Name (Legal Business Name): COFFEY COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N 4TH ST
BURLINGTON KS
66839-2602
US

IV. Provider business mailing address

801 N 4TH ST
BURLINGTON KS
66839-2602
US

V. Phone/Fax

Practice location:
  • Phone: 620-364-2121
  • Fax: 620-364-4525
Mailing address:
  • Phone: 620-364-2121
  • Fax: 620-364-2605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: STACY NICOLE AUGUSTYN
Title or Position: CEO
Credential:
Phone: 620-364-2121