Provider Demographics
NPI:1649462490
Name:GREENWOOD COUNTY HOSPITAL
Entity type:Organization
Organization Name:GREENWOOD COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-583-7979
Mailing Address - Street 1:1602 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:KS
Mailing Address - Zip Code:67045-1090
Mailing Address - Country:US
Mailing Address - Phone:620-583-7436
Mailing Address - Fax:620-583-6848
Practice Address - Street 1:410 MERCHANT AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:KS
Practice Address - Zip Code:67047
Practice Address - Country:US
Practice Address - Phone:620-658-4871
Practice Address - Fax:620-658-4871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service