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General NPI Number Information
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NPI Number | 1437152766
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Entity Type | Organization
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Legal Business Name | KIOWA DISTRICT HOSPITAL
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1002 S 4TH ST
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City | KIOWA
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State | KS
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Zip | 67070-1825
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Country | US
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Telephone | 620-825-4131
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Fax | 620-825-4667
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Provider Business Mailing Address
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Address Line | 1002 S 4TH ST
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City | KIOWA
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State | KS
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Zip | 67070-1825
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Country | US
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Telephone | 620-825-4131
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Fax | 620-825-4667
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Authorized Official
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Title or Position | CFO
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Name | JANELL LYN GOODNO
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Credential |
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Telephone | 620-825-4131
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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 | H-004-001
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License Number State | KS
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