Provider Demographics
NPI:1891798716
Name:SALEM HOSPITAL, INC.
Entity Type:Organization
Organization Name:SALEM HOSPITAL, INC.
Other - Org Name:HILLSBORO COMMUNITY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARION
Authorized Official - Middle Name:A
Authorized Official - Last Name:REGIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-947-3114
Mailing Address - Street 1:701 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:KS
Mailing Address - Zip Code:67063-1500
Mailing Address - Country:US
Mailing Address - Phone:620-947-3114
Mailing Address - Fax:620-947-5690
Practice Address - Street 1:701 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:KS
Practice Address - Zip Code:67063-1500
Practice Address - Country:US
Practice Address - Phone:620-947-3114
Practice Address - Fax:620-947-5690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-057-002282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100080570AMedicaid
KS000109OtherBLUE CROSS & BLUE SHIELD
KS171357Medicare Oscar/Certification