Provider Demographics
NPI:1639264492
Name:PHILLIPS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:PHILLIPS COUNTY HOSPITAL
Other - Org Name:PHILLIPS COUNTY HEALTH SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-540-4925
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-0607
Mailing Address - Country:US
Mailing Address - Phone:785-543-5226
Mailing Address - Fax:785-543-6272
Practice Address - Street 1:1150 STATE ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-1743
Practice Address - Country:US
Practice Address - Phone:785-543-5226
Practice Address - Fax:785-543-6272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RP1001X, 208600000X, 213EP1101X
KSH-074-001367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS012101OtherCRNA BLUE CROSS