Provider Demographics
NPI:1366599342
Name:OSBORNE COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:OSBORNE COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-346-2121
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:OSBORNE
Mailing Address - State:KS
Mailing Address - Zip Code:67473-0070
Mailing Address - Country:US
Mailing Address - Phone:785-346-2121
Mailing Address - Fax:785-346-5498
Practice Address - Street 1:237 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:OSBORNE
Practice Address - State:KS
Practice Address - Zip Code:67473-1500
Practice Address - Country:US
Practice Address - Phone:785-346-2121
Practice Address - Fax:785-346-5498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS001633OtherBLUE SHIELD
KS17-Z364Medicare Oscar/Certification