Healthcare Provider Details

I. General information

NPI: 1689246753
Provider Name (Legal Business Name): PRATT REGIONAL MEDICAL CENTER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E 1ST ST
PRATT KS
67124-2070
US

IV. Provider business mailing address

200 COMMODORE ST
PRATT KS
67124-2903
US

V. Phone/Fax

Practice location:
  • Phone: 620-770-4117
  • Fax:
Mailing address:
  • Phone: 620-672-7451
  • Fax: 620-672-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAMMY SMITH
Title or Position: CEO
Credential:
Phone: 620-672-7451