Healthcare Provider Details

I. General information

NPI: 1710525985
Provider Name (Legal Business Name): HILLSBORO HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 INDUSTRIAL RD
HILLSBORO KS
67063-9602
US

IV. Provider business mailing address

101 INDUSTRIAL RD
HILLSBORO KS
67063-9602
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DARREL MORRIS
Title or Position: COO
Credential:
Phone: 918-527-1234