Provider Demographics
NPI:1780641118
Name:MNMCH, INC
Entity Type:Organization
Organization Name:MNMCH, INC
Other - Org Name:ST. JOHN'S MAUDE NORTON MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-429-2545
Mailing Address - Street 1:220 N PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:KS
Mailing Address - Zip Code:66725-1110
Mailing Address - Country:US
Mailing Address - Phone:620-429-2545
Mailing Address - Fax:620-429-1984
Practice Address - Street 1:220 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:KS
Practice Address - Zip Code:66725-1110
Practice Address - Country:US
Practice Address - Phone:620-429-2545
Practice Address - Fax:620-429-1984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH011002282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS171308Medicare PIN