Provider Demographics
NPI:1063489219
Name:STEVENS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:STEVENS COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STALCUP
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:620-544-8511
Mailing Address - Street 1:1006 JACKSON STREET
Mailing Address - Street 2:PO BOX 10
Mailing Address - City:HUGOTON
Mailing Address - State:KS
Mailing Address - Zip Code:67951
Mailing Address - Country:US
Mailing Address - Phone:620-544-8511
Mailing Address - Fax:620-544-7822
Practice Address - Street 1:1006 JACKSON STREET
Practice Address - Street 2:
Practice Address - City:HUGOTON
Practice Address - State:KS
Practice Address - Zip Code:67951
Practice Address - Country:US
Practice Address - Phone:620-544-8511
Practice Address - Fax:620-544-7822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
17Z335Medicare ID - Type Unspecified