Healthcare Provider Details

I. General information

NPI: 1962563023
Provider Name (Legal Business Name): HERINGTON MUNICIPAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E HELEN STREET
HERINGTON KS
67449-1697
US

IV. Provider business mailing address

100 E HELEN STREET
HERINGTON KS
67449-1697
US

V. Phone/Fax

Practice location:
  • Phone: 785-258-2207
  • Fax: 785-258-3535
Mailing address:
  • Phone: 785-258-2207
  • Fax: 785-258-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number12282
License Number StateKS

VIII. Authorized Official

Name: MICHAEL RYAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 785-258-2207