Healthcare Provider Details

I. General information

NPI: 1003964677
Provider Name (Legal Business Name): STANTON COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 N. CHESTNUT ST.
JOHNSON KS
67855-0779
US

IV. Provider business mailing address

PO BOX 779 404 N. CHESTNUT ST.
JOHNSON KS
67855-0779
US

V. Phone/Fax

Practice location:
  • Phone: 620-492-6250
  • Fax: 620-492-1447
Mailing address:
  • Phone: 620-492-6250
  • Fax: 620-492-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH094001
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberH094001
License Number StateKS

VIII. Authorized Official

Name: CAMILLE DAVIDSON
Title or Position: CEO
Credential:
Phone: 620-492-6250