Provider Demographics
NPI:1548406309
Name:HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY
Entity Type:Organization
Organization Name:HOSPITAL DISTRICT NO 1 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:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:DULING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-724-8291
Mailing Address - Street 1:307 N HOSPITAL DR STE 5
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:KS
Mailing Address - Zip Code:66743-2047
Mailing Address - Country:US
Mailing Address - Phone:620-724-4659
Mailing Address - Fax:620-724-6955
Practice Address - Street 1:307 N HOSPITAL DR STE 5
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:KS
Practice Address - Zip Code:66743-2047
Practice Address - Country:US
Practice Address - Phone:620-724-4659
Practice Address - Fax:620-724-6955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL DISTRICT NO 1 CRAWFORD COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-29
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
KSH-019-001261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS178552Medicare Oscar/Certification