Provider Demographics
NPI:1619907482
Name:HERINGTON MUNICIPAL HOSPITAL
Entity Type:Organization
Organization Name:HERINGTON MUNICIPAL HOSPITAL
Other - Org Name:HERINGTON MUNICIPAL HOSPITAL SWING BED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-258-2207
Mailing Address - Street 1:100 E HELEN STREET
Mailing Address - Street 2:
Mailing Address - City:HERINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67449-1697
Mailing Address - Country:US
Mailing Address - Phone:785-258-2207
Mailing Address - Fax:785-258-3535
Practice Address - Street 1:100 E HELEN STREET
Practice Address - Street 2:
Practice Address - City:HERINGTON
Practice Address - State:KS
Practice Address - Zip Code:67449-1697
Practice Address - Country:US
Practice Address - Phone:785-258-2207
Practice Address - Fax:785-258-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH021002275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS10098980AMedicaid
KS17Z340Medicare Oscar/Certification