Provider Demographics
NPI:1366489817
Name:THE CLARA BARTON HOSPITAL ASSOCIATION INC HOISINGTON KANSAS
Entity Type:Organization
Organization Name:THE CLARA BARTON HOSPITAL ASSOCIATION INC HOISINGTON KANSAS
Other - Org Name:CLARA BARTON MEDICAL CARE - RUSSELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TUSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-653-2114
Mailing Address - Street 1:250 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HOISINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67544-1706
Mailing Address - Country:US
Mailing Address - Phone:620-653-5067
Mailing Address - Fax:620-653-5070
Practice Address - Street 1:410 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KS
Practice Address - Zip Code:67665-2759
Practice Address - Country:US
Practice Address - Phone:785-483-3811
Practice Address - Fax:785-483-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003913800006Medicaid
KS200259780AMedicaid
IA110662OtherBCBS
KS178519Medicare PIN