Provider Demographics
NPI:1346302502
Name:HERINGTON MUNICIPAL HOSPITAL
Entity Type:Organization
Organization Name:HERINGTON MUNICIPAL HOSPITAL
Other - Org Name:HERINGTON MUNICIPAL HOSPITAL PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-258-2207
Mailing Address - Street 1:100 EAST HELEN STREET
Mailing Address - Street 2:
Mailing Address - City:HERINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67449-1697
Mailing Address - Country:US
Mailing Address - Phone:785-258-2207
Mailing Address - Fax:785-258-3535
Practice Address - Street 1:100 EAST HELEN STREET
Practice Address - Street 2:
Practice Address - City:HERINGTON
Practice Address - State:KS
Practice Address - Zip Code:67449-1697
Practice Address - Country:US
Practice Address - Phone:785-258-2207
Practice Address - Fax:785-258-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS014053207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS14053OtherBCBS-PC
KS10098980AMedicaid
KS14053OtherBCBS-PC
KS10098980AMedicaid
KS014053Medicare ID - Type UnspecifiedPC