Provider Demographics
NPI:1629587803
Name:EDWARDS COUNTY HOSPITAL AND HEALTHCARE CENTER
Entity Type:Organization
Organization Name:EDWARDS COUNTY HOSPITAL AND HEALTHCARE CENTER
Other - Org Name:EDWARDS COUNTY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JIMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:620-659-3621
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:KINSLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67547-0099
Mailing Address - Country:US
Mailing Address - Phone:620-659-3621
Mailing Address - Fax:620-659-3869
Practice Address - Street 1:807 E 4TH ST
Practice Address - Street 2:
Practice Address - City:KINSLEY
Practice Address - State:KS
Practice Address - Zip Code:67547-1219
Practice Address - Country:US
Practice Address - Phone:620-659-3621
Practice Address - Fax:620-659-3869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center