Provider Demographics
NPI:1245392471
Name:MEDICAL CENTER, P.A.
Entity Type:Organization
Organization Name:MEDICAL CENTER, P.A.
Other - Org Name:MEDICAL CENTER WEST RHC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HANZLICEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-669-6690
Mailing Address - Street 1:1100 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-4406
Mailing Address - Country:US
Mailing Address - Phone:620-669-6690
Mailing Address - Fax:620-694-4152
Practice Address - Street 1:1125 N MAIN
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501
Practice Address - Country:US
Practice Address - Phone:620-669-6691
Practice Address - Fax:620-669-6645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
178985Medicare ID - Type UnspecifiedMEDICARE RURAL HEALTH