Provider Demographics
NPI:1447467162
Name:GEARY COUNTY HOSPITAL
Entity type:Organization
Organization Name:GEARY COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-238-4131
Mailing Address - Street 1:1106 SAINT MARYS RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-4158
Mailing Address - Country:US
Mailing Address - Phone:785-762-4255
Mailing Address - Fax:785-762-2859
Practice Address - Street 1:1106 SAINT MARYS RD
Practice Address - Street 2:SUITE 307
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-4158
Practice Address - Country:US
Practice Address - Phone:785-762-4255
Practice Address - Fax:785-762-2859
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEARY COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-19045207RG0300X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS10193980AMedicaid
KS10193980AMedicaid
KS002009Medicare ID - Type Unspecified