MEDICARE: LINDSBORG COMMUNITY HOSPITAL ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NC0060X	Critical Access Hospital

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	016774	OTHER	KS	MEDICARE

General Provider Information

NPI Number	:	1770057150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDSBORG COMMUNITY HOSPITAL ASSOCIATION

Provider Business Mailing Address
First Line	:	605 W LINCOLN ST
Second Line	:
City	:	LINDSBORG
State	:	KS
Zip	:	67456-2328
Country	:	US
Telephone Number	:	785-227-3308
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 N CHESTNUT ST
Second Line	:
City	:	LINDSBORG
State	:	KS
Zip	:	67456-1904
Country	:	US
Telephone Number	:	785-227-3371
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	LARAINE I GENGLER
Credential	:
Telephone Number	:	785-227-3308

Provider Enumeration Date	:	01/18/2019
Last Update Date	:	01/18/2019

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