Provider Demographics
NPI:1467569442
Name:PAWNEE VALLEY COMMUNITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:PAWNEE VALLEY COMMUNITY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-623-5523
Mailing Address - Street 1:923 CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:LARNED
Mailing Address - State:KS
Mailing Address - Zip Code:67550-2429
Mailing Address - Country:US
Mailing Address - Phone:620-285-3161
Mailing Address - Fax:
Practice Address - Street 1:923 CARROLL AVE
Practice Address - Street 2:
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550-2429
Practice Address - Country:US
Practice Address - Phone:620-285-3161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110743Medicare Oscar/Certification