Provider Demographics
NPI:1386678431
Name:CITIZENS MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:CITIZENS MEDICAL CENTER, INC.
Other - Org Name:CITIZENS MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:W
Authorized Official - Last Name:UNRUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-460-4801
Mailing Address - Street 1:100 E COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-3702
Mailing Address - Country:US
Mailing Address - Phone:785-462-7511
Mailing Address - Fax:785-460-4870
Practice Address - Street 1:100 E COLLEGE DR
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-3702
Practice Address - Country:US
Practice Address - Phone:785-462-7511
Practice Address - Fax:785-460-4870
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITIZENS MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-11
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH097001282NC0060X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000164OtherBLUE CROSS
KS100098840AMedicaid
KSH097001Medicare Oscar/Certification
KS1467620001Medicare NSC
KS171362Medicare PIN