Provider Demographics
NPI:1396851259
Name:FOWLER HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:FOWLER HOSPITAL DISTRICT
Other - Org Name:FOWLER RESIDENTIAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-646-5215
Mailing Address - Street 1:P.O. BOX 20
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:KS
Mailing Address - Zip Code:67844-0020
Mailing Address - Country:US
Mailing Address - Phone:620-646-5215
Mailing Address - Fax:620-646-5657
Practice Address - Street 1:401 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:KS
Practice Address - Zip Code:67844-0020
Practice Address - Country:US
Practice Address - Phone:620-646-5215
Practice Address - Fax:620-646-5657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN-060-002313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100109320AMedicaid
KS100109320AMedicaid