Provider Demographics
NPI:1508897182
Name:HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY
Entity Type:Organization
Organization Name:HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-724-8291
Mailing Address - Street 1:302 N HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:KS
Mailing Address - Zip Code:66743-2000
Mailing Address - Country:US
Mailing Address - Phone:620-724-8291
Mailing Address - Fax:620-724-6332
Practice Address - Street 1:302 N HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:KS
Practice Address - Zip Code:66743-2000
Practice Address - Country:US
Practice Address - Phone:620-724-8291
Practice Address - Fax:620-724-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100004200BMedicaid
KS009214Medicare Oscar/Certification