Provider Demographics
NPI:1114035102
Name:GREENWOOD COUNTY HOSPITAL
Entity Type:Organization
Organization Name:GREENWOOD COUNTY HOSPITAL
Other - Org Name:HOWARD CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:N
Authorized Official - Last Name:HENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-583-7451
Mailing Address - Street 1:118 S WABASH ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:KS
Mailing Address - Zip Code:67349
Mailing Address - Country:US
Mailing Address - Phone:620-374-2650
Mailing Address - Fax:620-374-2789
Practice Address - Street 1:118 S WABASH ST
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:KS
Practice Address - Zip Code:67349
Practice Address - Country:US
Practice Address - Phone:620-374-2650
Practice Address - Fax:620-374-2789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS178544Medicare Oscar/Certification