Provider Demographics
NPI:1184670911
Name:HOSPITAL DISTRICT NO. 1 OF DICKINSON COUNTY, KANSAS
Entity Type:Organization
Organization Name:HOSPITAL DISTRICT NO. 1 OF DICKINSON COUNTY, KANSAS
Other - Org Name:HOME HEALTH OF DICKINSON COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:COURTOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-263-6610
Mailing Address - Street 1:1111 N BRADY ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-1804
Mailing Address - Country:US
Mailing Address - Phone:785-263-6630
Mailing Address - Fax:785-263-6636
Practice Address - Street 1:1111 N BRADY ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-1804
Practice Address - Country:US
Practice Address - Phone:785-263-6630
Practice Address - Fax:785-263-6636
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL DISTRICT NO. 1 OF DICKINSON COUNTY, KANSAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-25
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA 021 005251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003942230010Medicaid