Provider Demographics
NPI:1447280078
Name:SCOTT COUNTY HOSPITAL, INC
Entity type:Organization
Organization Name:SCOTT COUNTY HOSPITAL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:D MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-872-5811
Mailing Address - Street 1:110 E. 4TH STR.
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67871
Mailing Address - Country:US
Mailing Address - Phone:620-874-4868
Mailing Address - Fax:620-872-5014
Practice Address - Street 1:110 E 4TH ST
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:KS
Practice Address - Zip Code:67871-1254
Practice Address - Country:US
Practice Address - Phone:620-874-4868
Practice Address - Fax:620-872-5014
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCOTT COUNTY HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-03
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000557OtherBCBS HH #
KS000557OtherBCBS
KS000557OtherBCBS OF KS
KS100091670DMedicaid
KS177084Medicare Oscar/Certification