Healthcare Provider Details

I. General information

NPI: 1447986757
Provider Name (Legal Business Name): MINNEOLA DISTRICT HOSPITAL NBR 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ROSS BLVD
DODGE CITY KS
67801-7221
US

IV. Provider business mailing address

212 MAIN ST
MINNEOLA KS
67865-8511
US

V. Phone/Fax

Practice location:
  • Phone: 620-371-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH BRUNER
Title or Position: CEO
Credential:
Phone: 620-885-4264