Healthcare Provider Details

I. General information

NPI: 1316999246
Provider Name (Legal Business Name): SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CHEYENNE
SATANTA KS
67870-8748
US

IV. Provider business mailing address

PO BOX 159
SATANTA KS
67870-0159
US

V. Phone/Fax

Practice location:
  • Phone: 620-649-2771
  • Fax: 620-649-2538
Mailing address:
  • Phone: 620-649-2771
  • Fax: 620-649-2538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberH-041-001
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: TINA PENDERGRAFT
Title or Position: ADMINISTRATOR
Credential:
Phone: 620-649-2761