Healthcare Provider Details

I. General information

NPI: 1508897182
Provider Name (Legal Business Name): HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 N HOSPITAL DR
GIRARD KS
66743-2000
US

IV. Provider business mailing address

302 N HOSPITAL DR
GIRARD KS
66743-2000
US

V. Phone/Fax

Practice location:
  • Phone: 620-724-8291
  • Fax: 620-724-6332
Mailing address:
  • Phone: 620-724-8291
  • Fax: 620-724-6332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: HOLLY KOCH
Title or Position: CFO
Credential:
Phone: 620-724-8291