Healthcare Provider Details

I. General information

NPI: 1962408914
Provider Name (Legal Business Name): SUMNER REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 N. A. STREET
WELLINGTON KS
67152-4350
US

IV. Provider business mailing address

1323 N. A. STREET
WELLINGTON KS
67152-4350
US

V. Phone/Fax

Practice location:
  • Phone: 620-326-7451
  • Fax: 620-326-2225
Mailing address:
  • Phone: 620-326-7451
  • Fax: 620-326-2225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberH096002
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH-096-002
License Number StateKS

VIII. Authorized Official

Name: MR. KIM M. WEAVER
Title or Position: CFO
Credential:
Phone: 620-326-7451