Healthcare Provider Details

I. General information

NPI: 1801043906
Provider Name (Legal Business Name): CAH ACQUISITION COMPANY 5 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 INDUSTRIAL ROAD
HILLSBORO KS
67063
US

IV. Provider business mailing address

101 INDUSTRIAL ROAD
HILLSBORO KS
67063-9602
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 Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH-057-002
License Number StateKS

VIII. Authorized Official

Name: MARION A REGIER
Title or Position: CEO
Credential:
Phone: 620-947-3114