Provider Demographics
NPI:1114282563
Name:KEARNY COUNTY HOSPITAL
Entity Type:Organization
Organization Name:KEARNY COUNTY HOSPITAL
Other - Org Name:FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-355-7111
Mailing Address - Street 1:506 E THORPE ST
Mailing Address - Street 2:
Mailing Address - City:LAKIN
Mailing Address - State:KS
Mailing Address - Zip Code:67860-9625
Mailing Address - Country:US
Mailing Address - Phone:620-355-7550
Mailing Address - Fax:620-355-7500
Practice Address - Street 1:521 MAIN STREET
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:KS
Practice Address - Zip Code:67838-0361
Practice Address - Country:US
Practice Address - Phone:620-426-2990
Practice Address - Fax:620-426-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0100X
KSH-047-001261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100021960NMedicaid
KS100021960AMedicaid
KS100021960NMedicaid
KS100021960AMedicaid