Provider Demographics
NPI:1750687216
Name:GREENWOOD COUNTY HOSPITAL
Entity Type:Organization
Organization Name:GREENWOOD COUNTY HOSPITAL
Other - Org Name:GREENWOOD MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-583-7451
Mailing Address - Street 1:105 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:KS
Mailing Address - Zip Code:67045
Mailing Address - Country:US
Mailing Address - Phone:620-583-5967
Mailing Address - Fax:620-583-5525
Practice Address - Street 1:105 W 16TH ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:KS
Practice Address - Zip Code:67045
Practice Address - Country:US
Practice Address - Phone:620-583-5967
Practice Address - Fax:620-583-5525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH037001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS6572970001OtherMEDICARE PTAN