Provider Demographics
NPI:1912310822
Name:PAWNEE VALLEY COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:PAWNEE VALLEY COMMUNITY HOSPITAL INC
Other - Org Name:PAWNEE VALLEY COMMUNITY HOSPITAL FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-623-5523
Mailing Address - Street 1:713 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LARNED
Mailing Address - State:KS
Mailing Address - Zip Code:67550-2055
Mailing Address - Country:US
Mailing Address - Phone:620-804-6007
Mailing Address - Fax:620-285-6195
Practice Address - Street 1:713 W 11TH ST
Practice Address - Street 2:
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550-2055
Practice Address - Country:US
Practice Address - Phone:620-804-6007
Practice Address - Fax:620-285-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty