Provider Demographics
NPI:1497724744
Name:STEVENS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:STEVENS COUNTY HOSPITAL
Other - Org Name:STEVENS COUNTY HOSPITAL HOME HEALTH AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:FEATHERSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-544-6178
Mailing Address - Street 1:1006 S JACKSON ST
Mailing Address - Street 2:BOX 10
Mailing Address - City:HUGOTON
Mailing Address - State:KS
Mailing Address - Zip Code:67951-2858
Mailing Address - Country:US
Mailing Address - Phone:620-544-7157
Mailing Address - Fax:620-544-7822
Practice Address - Street 1:1006 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:HUGOTON
Practice Address - State:KS
Practice Address - Zip Code:67951-2858
Practice Address - Country:US
Practice Address - Phone:620-544-7157
Practice Address - Fax:620-544-7822
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEVENS COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-17
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA095001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS5830061101Medicaid
177149Medicare Oscar/Certification