Provider Demographics
NPI:1437112687
Name:COUNTY OF LANE
Entity Type:Organization
Organization Name:COUNTY OF LANE
Other - Org Name:LANE COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCGOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-397-5321
Mailing Address - Street 1:235 WEST VINE STREET
Mailing Address - Street 2:POST OFFICE BOX 969
Mailing Address - City:DIGHTON
Mailing Address - State:KS
Mailing Address - Zip Code:67839-0969
Mailing Address - Country:US
Mailing Address - Phone:620-397-5321
Mailing Address - Fax:620-397-2823
Practice Address - Street 1:235 W. VINE ST.
Practice Address - Street 2:
Practice Address - City:DIGHTON
Practice Address - State:KS
Practice Address - Zip Code:67839-0969
Practice Address - Country:US
Practice Address - Phone:620-397-5321
Practice Address - Fax:620-397-2823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH051001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000199OtherBLUE CROSS
KS100098890AMedicaid
KS171303Medicare Oscar/Certification