Provider Demographics
NPI:1023175064
Name:HIAWATHA HOSPITAL ASSOCIATION INC
Entity type:Organization
Organization Name:HIAWATHA HOSPITAL ASSOCIATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-742-2131
Mailing Address - Street 1:300 UTAH ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2326
Mailing Address - Country:US
Mailing Address - Phone:785-742-2131
Mailing Address - Fax:785-742-6554
Practice Address - Street 1:300 UTAH ST FL 2
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2314
Practice Address - Country:US
Practice Address - Phone:785-742-2161
Practice Address - Fax:785-742-6554
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIAWATHA HOSPITAL ASSOCIATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-02
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100098990BMedicaid
KS100098990EMedicaid
KS100098990EMedicaid
KS173464Medicare Oscar/Certification