Healthcare Provider Details

I. General information

NPI: 1649462490
Provider Name (Legal Business Name): GREENWOOD COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 MERCHANT AVE
FALL RIVER KS
67047
US

IV. Provider business mailing address

1602 N ELM ST
EUREKA KS
67045-1090
US

V. Phone/Fax

Practice location:
  • Phone: 620-658-4871
  • Fax: 620-658-4871
Mailing address:
  • Phone: 620-583-7436
  • Fax: 620-583-6848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIAN K DRAKE
Title or Position: DIRECTOR
Credential:
Phone: 620-583-7979