Provider Demographics
NPI:1528376035
Name:HOSPITAL DISTRICT #1 OF CRAWFORD COUNTY
Entity Type:Organization
Organization Name:HOSPITAL DISTRICT #1 OF CRAWFORD COUNTY
Other - Org Name:GIRARD MEDICAL CENTER HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:620-724-8281
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 1:307 N HOSPITAL DR
Practice Address - Street 2:SUITE 5
Practice Address - City:GIRARD
Practice Address - State:KS
Practice Address - Zip Code:66743-2014
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:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100004200VMedicaid