Provider Demographics
NPI:1114470010
Name:ST CATHERINE HOSPITAL
Entity Type:Organization
Organization Name:ST CATHERINE HOSPITAL
Other - Org Name:CENTURA HEALTH CONVENIENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-272-2554
Mailing Address - Street 1:401 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5679
Mailing Address - Country:US
Mailing Address - Phone:620-272-2222
Mailing Address - Fax:620-272-2216
Practice Address - Street 1:2051 E MARY ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-3617
Practice Address - Country:US
Practice Address - Phone:620-272-2222
Practice Address - Fax:620-272-2216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST CATHERINE EMERGENCY PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty