Provider Demographics
NPI:1730254673
Name:GOODLAND REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:GOODLAND REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INS/PT ACCTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-890-6012
Mailing Address - Street 1:220 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GOODLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67735-1602
Mailing Address - Country:US
Mailing Address - Phone:785-890-3625
Mailing Address - Fax:
Practice Address - Street 1:220 W 2ND ST
Practice Address - Street 2:
Practice Address - City:GOODLAND
Practice Address - State:KS
Practice Address - Zip Code:67735-1602
Practice Address - Country:US
Practice Address - Phone:785-890-3625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH091001275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS001603OtherBLUE CROSS SWING BED
KS17Z370Medicare Oscar/Certification