Provider Demographics
NPI:1437240595
Name:OSBORNE COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:OSBORNE COUNTY MEMORIAL HOSPITAL
Other - Org Name:GOAD MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-346-2121
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:OSBORNE
Mailing Address - State:KS
Mailing Address - Zip Code:67473-0070
Mailing Address - Country:US
Mailing Address - Phone:785-346-2510
Mailing Address - Fax:785-345-4163
Practice Address - Street 1:237 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:OSBORNE
Practice Address - State:KS
Practice Address - Zip Code:67473-1500
Practice Address - Country:US
Practice Address - Phone:785-346-2510
Practice Address - Fax:785-345-4163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
KS261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
110866OtherBLUE SHIELD/MED PART B
KS110866Medicare PIN
KS110866Medicare Oscar/Certification