Provider Demographics
NPI:1518995034
Name:MORTON COUNTY HOSPITAL
Entity Type:Organization
Organization Name:MORTON COUNTY HOSPITAL
Other - Org Name:MORTON COUNTY HOSPITAL PSYCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-697-2141
Mailing Address - Street 1:PO BOX 937
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:KS
Mailing Address - Zip Code:67950-0937
Mailing Address - Country:US
Mailing Address - Phone:620-697-2141
Mailing Address - Fax:620-697-4766
Practice Address - Street 1:445 HILLTOP STREET
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:KS
Practice Address - Zip Code:67950
Practice Address - Country:US
Practice Address - Phone:620-697-2141
Practice Address - Fax:620-697-4766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH065001273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000190OtherBCBS
KS100087540AMedicaid
KS17S166Medicare ID - Type Unspecified