Healthcare Provider Details

I. General information

NPI: 1114282563
Provider Name (Legal Business Name): KEARNY COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 MAIN STREET
DEERFIELD KS
67838-0361
US

IV. Provider business mailing address

506 E THORPE ST
LAKIN KS
67860-9625
US

V. Phone/Fax

Practice location:
  • Phone: 620-426-2990
  • Fax: 620-426-2991
Mailing address:
  • Phone: 620-355-7550
  • Fax: 620-355-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberH-047-001
License Number StateKS

VIII. Authorized Official

Name: DAVID HOFMEISTER
Title or Position: ADMINISTRATOR CEO
Credential:
Phone: 620-355-7111