Provider Demographics
NPI:1336184647
Name:JEWELL COUNTY HOSPITAL
Entity Type:Organization
Organization Name:JEWELL COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASST.
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-378-3137
Mailing Address - Street 1:100 CRESTVUE AVE
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:KS
Mailing Address - Zip Code:66956-2407
Mailing Address - Country:US
Mailing Address - Phone:785-378-3137
Mailing Address - Fax:785-378-3450
Practice Address - Street 1:100 CRESTVUE AVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:KS
Practice Address - Zip Code:66956-2407
Practice Address - Country:US
Practice Address - Phone:785-378-3137
Practice Address - Fax:785-378-3450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH045001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS227OtherBLUE CROSS BLUE SHIELD KS
KS110264OtherBLUE CROSS BLUE SHIELD KS
KS633590OtherFIRSTGUARD
KS100099530AMedicaid
KS227OtherBLUE CROSS BLUE SHIELD KS
KS110264OtherBLUE CROSS BLUE SHIELD KS