Provider Demographics
NPI:1093747693
Name:BUCKLIN DISTRICT HOSPITAL
Entity Type:Organization
Organization Name:BUCKLIN DISTRICT HOSPITAL
Other - Org Name:HILL TOP HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KREGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-826-3202
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:BUCKLIN
Mailing Address - State:KS
Mailing Address - Zip Code:67834-0248
Mailing Address - Country:US
Mailing Address - Phone:620-826-3202
Mailing Address - Fax:620-826-3591
Practice Address - Street 1:505 W. ELM
Practice Address - Street 2:
Practice Address - City:BUCKLIN
Practice Address - State:KS
Practice Address - Zip Code:67834-0248
Practice Address - Country:US
Practice Address - Phone:620-826-3202
Practice Address - Fax:620-826-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN029004310400000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100065760AMedicaid
KS100108670AMedicaid
KS175500Medicare Oscar/Certification