Provider Demographics
NPI:1346013612
Name:SEDGWICK COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SEDGWICK COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AIDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HETTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-463-6163
Mailing Address - Street 1:900 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:JULESBURG
Mailing Address - State:CO
Mailing Address - Zip Code:80737-1121
Mailing Address - Country:US
Mailing Address - Phone:970-474-3323
Mailing Address - Fax:970-474-2758
Practice Address - Street 1:758 2ND ST
Practice Address - Street 2:
Practice Address - City:CHAPPELL
Practice Address - State:NE
Practice Address - Zip Code:69129-6876
Practice Address - Country:US
Practice Address - Phone:970-474-3323
Practice Address - Fax:970-474-2758
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEDGWICK COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health