Provider Demographics
NPI:1174576532
Name:HOSPITAL DISTRICT NO. 1 OF DICKINSON COUNTY, KANSAS
Entity type:Organization
Organization Name:HOSPITAL DISTRICT NO. 1 OF DICKINSON COUNTY, KANSAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:COURTOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-263-6610
Mailing Address - Street 1:705 N BRADY ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-2113
Mailing Address - Country:US
Mailing Address - Phone:785-263-1431
Mailing Address - Fax:785-263-7407
Practice Address - Street 1:705 N BRADY ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2113
Practice Address - Country:US
Practice Address - Phone:785-263-1431
Practice Address - Fax:785-263-7407
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL DISTRICT #1 OF DICKINSON COUNTY, KANSAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-18
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH 021 001314000000X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003942230003Medicaid
KS100445650AMedicaid
KS00858OtherBCBS OF KS