Provider Demographics
NPI:1346403284
Name:ST CATHERINE HOSPITAL
Entity Type:Organization
Organization Name:ST CATHERINE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-275-9752
Mailing Address - Street 1:115 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5459
Mailing Address - Country:US
Mailing Address - Phone:620-275-9752
Mailing Address - Fax:620-275-4306
Practice Address - Street 1:115 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5459
Practice Address - Country:US
Practice Address - Phone:620-275-9752
Practice Address - Fax:620-275-4306
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST CATHERINE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-09
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty