Healthcare Provider Details

I. General information

NPI: 1568400737
Provider Name (Legal Business Name): SALEM HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S MAIN ST
HILLSBORO KS
67063-1500
US

IV. Provider business mailing address

701 S MAIN ST
HILLSBORO KS
67063-1500
US

V. Phone/Fax

Practice location:
  • Phone: 620-947-3114
  • Fax: 620-947-5690
Mailing address:
  • Phone: 620-947-3114
  • Fax: 620-947-5690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J RYAN
Title or Position: CEO
Credential:
Phone: 620-947-1410