Provider Demographics
NPI:1932136074
Name:HAMILTON COUNTY HOSPITAL
Entity Type:Organization
Organization Name:HAMILTON COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:BULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-384-5519
Mailing Address - Street 1:PO BOX 948
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:KS
Mailing Address - Zip Code:67878-0948
Mailing Address - Country:US
Mailing Address - Phone:620-384-7461
Mailing Address - Fax:620-384-5500
Practice Address - Street 1:700 NORTH HUSER
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:KS
Practice Address - Zip Code:67878-0948
Practice Address - Country:US
Practice Address - Phone:620-384-7461
Practice Address - Fax:620-384-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH038001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000228OtherBLUE CROSS BLUE SHIELD
KS000228OtherBCBS
KS100099390AMedicaid
KS000228OtherBCBS