Provider Demographics
NPI:1386689586
Name:JEWELL COUNTY HOSPITAL
Entity Type:Organization
Organization Name:JEWELL COUNTY HOSPITAL
Other - Org Name:JEWELL COUNTY RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-378-3137
Mailing Address - Street 1:100 CRESTVUE AVE
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:KS
Mailing Address - Zip Code:66956-2407
Mailing Address - Country:US
Mailing Address - Phone:785-378-3137
Mailing Address - Fax:785-378-3450
Practice Address - Street 1:102 S CENTER ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:KS
Practice Address - Zip Code:66956-2202
Practice Address - Country:US
Practice Address - Phone:785-378-3511
Practice Address - Fax:785-378-3919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEWELL COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-19
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH045001261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110421OtherBLUE CROSS BLUE SHIELD KS
KS664280OtherFIRSTGUARD
KS100099530BMedicaid
NE=========12Medicaid
KS173479Medicare ID - Type Unspecified