Healthcare Provider Details

I. General information

NPI: 1245321819
Provider Name (Legal Business Name): PRATT REGIONAL MEDICAL CENTER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S MAIN ST
SYLVIA KS
67581
US

IV. Provider business mailing address

PO BOX 309
STAFFORD KS
67578-0309
US

V. Phone/Fax

Practice location:
  • Phone: 620-486-2985
  • Fax:
Mailing address:
  • Phone: 620-234-6826
  • Fax: 620-234-5014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUSAN PAGE
Title or Position: PRESIDENT & CEO
Credential:
Phone: 620-672-7451