=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588673297
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRAHAM COUNTY HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2006
-----------------------------------------------------
Last Update Date | 10/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 304 W PROUT ST
-----------------------------------------------------
City | HILL CITY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67642-1435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-421-2121
-----------------------------------------------------
Fax | 785-421-2034
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 304 W PROUT ST
-----------------------------------------------------
City | HILL CITY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67642-1435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-421-2121
-----------------------------------------------------
Fax | 785-421-2034
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JONATHAN GLEASON
-----------------------------------------------------
Credential | MBA
-----------------------------------------------------
Telephone | 785-421-2121
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NC0060X
-----------------------------------------------------
Taxonomy Name | Critical Access Hospital
-----------------------------------------------------
License Number | H033001
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------