Provider Demographics
NPI:1457998593
Name:ELLSWORTH COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:ELLSWORTH COUNTY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-472-3111
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:67439-0087
Mailing Address - Country:US
Mailing Address - Phone:785-472-3111
Mailing Address - Fax:785-472-5760
Practice Address - Street 1:1604 AYLWARD AVE
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:KS
Practice Address - Zip Code:67439-2541
Practice Address - Country:US
Practice Address - Phone:785-472-3111
Practice Address - Fax:785-472-5760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty