Provider Demographics
NPI:1629044961
Name:GREENWOOD COUNTY HOSPITAL
Entity Type:Organization
Organization Name:GREENWOOD COUNTY HOSPITAL
Other - Org Name:EUREKA CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-583-7451
Mailing Address - Street 1:100 WEST 16TH ST.
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:KS
Mailing Address - Zip Code:67045-1047
Mailing Address - Country:US
Mailing Address - Phone:620-583-5274
Mailing Address - Fax:620-583-5194
Practice Address - Street 1:100 WEST 16TH ST.
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:KS
Practice Address - Zip Code:67045-1047
Practice Address - Country:US
Practice Address - Phone:620-583-5274
Practice Address - Fax:620-583-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100070000GMedicaid
KS100070000GMedicaid