=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003859521
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRISELL MEMORIAL HOSPITAL DISTRICT 1
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2006
-----------------------------------------------------
Last Update Date | 07/02/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 S VERMONT AVE
-----------------------------------------------------
City | RANSOM
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67572-9525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-731-2231
-----------------------------------------------------
Fax | 785-731-2895
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 210 S VERMONT AVE
-----------------------------------------------------
City | RANSOM
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67572-9525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-731-2231
-----------------------------------------------------
Fax | 785-731-2895
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | FRANK SAFRIT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 785-731-2231
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NC0060X
-----------------------------------------------------
Taxonomy Name | Critical Access Hospital
-----------------------------------------------------
License Number | H068002
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 275N00000X
-----------------------------------------------------
Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
-----------------------------------------------------
License Number | H068002
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------