Provider Demographics
NPI:1033114277
Name:SEDAN CITY HOSPITAL
Entity Type:Organization
Organization Name:SEDAN CITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-725-3115
Mailing Address - Street 1:PO BOX C
Mailing Address - Street 2:
Mailing Address - City:SEDAN
Mailing Address - State:KS
Mailing Address - Zip Code:67361-0427
Mailing Address - Country:US
Mailing Address - Phone:620-725-3115
Mailing Address - Fax:620-725-3297
Practice Address - Street 1:300 W NORTH ST
Practice Address - Street 2:
Practice Address - City:SEDAN
Practice Address - State:KS
Practice Address - Zip Code:67361-1051
Practice Address - Country:US
Practice Address - Phone:620-725-3115
Practice Address - Fax:620-725-3297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH010002282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100695170AMedicaid
KS100104910AMedicaid
KS000962OtherBLUE CROSS
KS171318Medicare Oscar/Certification