Provider Demographics
NPI:1396843116
Name:MITCHELL COUNTY HOSPITAL HEALTH SYSTEMS
Entity Type:Organization
Organization Name:MITCHELL COUNTY HOSPITAL HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEPKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-738-2266
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:KS
Mailing Address - Zip Code:67420-0399
Mailing Address - Country:US
Mailing Address - Phone:785-738-2266
Mailing Address - Fax:785-738-9503
Practice Address - Street 1:400 WEST 8TH STREET
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:KS
Practice Address - Zip Code:67420-0399
Practice Address - Country:US
Practice Address - Phone:785-738-2266
Practice Address - Fax:785-738-9503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSHO62001273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17M375Medicare Oscar/Certification