Healthcare Provider Details

I. General information

NPI: 1861695835
Provider Name (Legal Business Name): GREENWOOD COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WEST 16TH ST.
EUREKA KS
67045-1047
US

IV. Provider business mailing address

100 WEST 16TH ST.
EUREKA KS
67045-1047
US

V. Phone/Fax

Practice location:
  • Phone: 620-583-5274
  • Fax: 620-583-5194
Mailing address:
  • Phone: 620-583-5274
  • Fax: 620-583-5194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY J MCKENZIE
Title or Position: CEO
Credential:
Phone: 620-583-7451