Healthcare Provider Details

I. General information

NPI: 1275531485
Provider Name (Legal Business Name): GREENWOOD COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W 16TH ST
EUREKA KS
67045-1064
US

IV. Provider business mailing address

100 W 16TH ST
EUREKA KS
67045-1064
US

V. Phone/Fax

Practice location:
  • Phone: 620-583-5909
  • Fax: 620-583-5189
Mailing address:
  • Phone: 620-583-5909
  • Fax: 620-583-5189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA-037-002
License Number StateKS

VIII. Authorized Official

Name: THOMAS HENTON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 620-583-7451