Healthcare Provider Details
I. General information
NPI: 1215045299
Provider Name (Legal Business Name): GREENWOOD COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2006
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1602 N ELM ST STE B
EUREKA KS
67045-1092
US
IV. Provider business mailing address
100 WEST 16TH ST.
EUREKA KS
67045-1047
US
V. Phone/Fax
- Phone: 620-583-5274
- Fax: 620-583-5194
- Phone: 620-583-5274
- Fax: 620-583-5194
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NANCY
J
MCKENZIE
Title or Position: CEO
Credential:
Phone: 620-583-7451