Provider Demographics
NPI:1659360196
Name:ST. CATHERINE HOSPITAL
Entity Type:Organization
Organization Name:ST. CATHERINE HOSPITAL
Other - Org Name:ST. CATHERINE HOSPITAL - GARDEN CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GROUP VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:TADD
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:719-571-7202
Mailing Address - Street 1:PO BOX 803929
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-3929
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:303-765-6670
Practice Address - Street 1:401 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5679
Practice Address - Country:US
Practice Address - Phone:620-272-2222
Practice Address - Fax:620-272-2127
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CATHERINE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-18
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH028001282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100088310AMedicaid
KS14352250OtherDEPARTMENT OF LABOR
KS233OtherKANSAS BLUE CROSS #
KS100088310CMedicaid
KS14094OtherBCBS - ER
KSC82244OtherMEDICARE RR
KS100088310CMedicaid