Healthcare Provider Details
I. General information
NPI: 1790790566
Provider Name (Legal Business Name): SEDGWICK COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 W 3RD ST
BIG SPRINGS NE
69122-5048
US
IV. Provider business mailing address
900 CEDAR ST
JULESBURG CO
80737-1121
US
V. Phone/Fax
- Phone: 308-889-3376
- Fax: 308-889-3378
- Phone: 970-474-3323
- Fax: 970-474-2758
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
GARNAS
Title or Position: CEO
Credential:
Phone: 970-474-3323