Provider Demographics
NPI:1184635229
Name:SHERIDAN COUNTY HOSPITAL
Entity Type:Organization
Organization Name:SHERIDAN COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:NIBLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-675-3281
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:826 18TH ST
Mailing Address - City:HOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:67740-0167
Mailing Address - Country:US
Mailing Address - Phone:785-675-3281
Mailing Address - Fax:785-675-3840
Practice Address - Street 1:826 18TH ST
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:KS
Practice Address - Zip Code:67740-0167
Practice Address - Country:US
Practice Address - Phone:785-675-3281
Practice Address - Fax:785-675-3840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH09001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100080380AMedicaid
KS171347Medicare Oscar/Certification