Provider Demographics
NPI:1639268246
Name:PHILLIPS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:PHILLIPS COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
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:2006-10-12
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-074-001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000168OtherHOSPITAL BLUE CROSS
KS100409050AMedicaid
KS17-1353Medicare Oscar/Certification