Provider Demographics
NPI:1821019605
Name:DECATUR HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:DECATUR HEALTH SYSTEMS INC
Other - Org Name:DECATUR HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-475-2208
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:KS
Mailing Address - Zip Code:67749-0268
Mailing Address - Country:US
Mailing Address - Phone:785-475-2208
Mailing Address - Fax:785-475-2453
Practice Address - Street 1:810 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:KS
Practice Address - Zip Code:67749-2450
Practice Address - Country:US
Practice Address - Phone:785-475-2208
Practice Address - Fax:785-475-2453
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DECATUR HEALTH SYSTEMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-020-001275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS001632OtherBCBS SWB
KS17Z352Medicare Oscar/Certification