Provider Demographics
NPI:1720005598
Name:WILLIAM NEWTON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:WILLIAM NEWTON MEMORIAL HOSPITAL
Other - Org Name:TALLGRASS RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:METZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-758-2221
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:300 NORTH STREET
Mailing Address - City:SEDAN
Mailing Address - State:KS
Mailing Address - Zip Code:67361-0308
Mailing Address - Country:US
Mailing Address - Phone:620-725-3818
Mailing Address - Fax:620-725-5433
Practice Address - Street 1:300 W NORTH ST
Practice Address - Street 2:
Practice Address - City:SEDAN
Practice Address - State:KS
Practice Address - Zip Code:67361-1051
Practice Address - Country:US
Practice Address - Phone:620-725-3818
Practice Address - Fax:620-725-5433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM NEWTON MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-16
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS173423261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100005090EMedicaid
KS100005090EMedicaid