Healthcare Provider Details

I. General information

NPI: 1720173669
Provider Name (Legal Business Name): LOGAN COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PRICE
OAKLEY KS
67748
US

IV. Provider business mailing address

211 CHERRY AVENUE
OAKLEY KS
67748-1201
US

V. Phone/Fax

Practice location:
  • Phone: 785-672-8109
  • Fax:
Mailing address:
  • Phone: 785-672-3211
  • Fax: 785-672-8184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberN-055-002
License Number StateKS

VIII. Authorized Official

Name: MR. JOEE SHANE MEYER
Title or Position: CFO
Credential:
Phone: 785-672-1409