Healthcare Provider Details

I. General information

NPI: 1255421210
Provider Name (Legal Business Name): HIAWATHA HOSPITAL ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 UTAH ST
HIAWATHA KS
66434-2314
US

IV. Provider business mailing address

300 UTAH ST
HIAWATHA KS
66434-2326
US

V. Phone/Fax

Practice location:
  • Phone: 785-742-2131
  • Fax: 785-742-6588
Mailing address:
  • Phone: 785-742-2131
  • Fax: 785-742-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH007001
License Number StateKS

VIII. Authorized Official

Name: MR. JARED ABEL
Title or Position: CEO
Credential:
Phone: 785-742-2131