Provider Demographics
NPI:1275531642
Name:KEARNY COUNTY HOSPITAL
Entity Type:Organization
Organization Name:KEARNY COUNTY HOSPITAL
Other - Org Name:HIGH PLAINS RETIREMENT VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position: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 1:500 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:620-355-7111
Mailing Address - Fax:620-355-1527
Practice Address - Street 1:607 COURT PL
Practice Address - Street 2:
Practice Address - City:LAKIN
Practice Address - State:KS
Practice Address - Zip Code:67860-9704
Practice Address - Country:US
Practice Address - Phone:620-355-7836
Practice Address - Fax:620-355-1527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-047-001313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100110730AMedicaid