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General NPI Number Information
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NPI Number | 1235167750
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Entity Type | Organization
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Legal Business Name | JEFFERSON COUNTY MEMORIAL HOSPITAL, INC
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 408 DELAWARE ST
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City | WINCHESTER
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State | KS
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Zip | 66097-4003
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Country | US
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Telephone | 913-933-4020
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Fax | 844-415-1702
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Provider Business Mailing Address
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Address Line | 408 DELAWARE ST
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City | WINCHESTER
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State | KS
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Zip | 66097-4003
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Country | US
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Telephone | 913-933-4020
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Fax | 844-415-1702
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. LAMONT M COOK
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Credential |
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Telephone | 913-933-4020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | HO44001
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License Number State | KS
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