Provider Demographics
NPI:1215256995
Name:STAFFORD COUNTY HOSPITAL
Entity type:Organization
Organization Name:STAFFORD COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-234-5221
Mailing Address - Street 1:412 GRAND AVE
Mailing Address - Street 2:PO BOX 190
Mailing Address - City:STAFFORD
Mailing Address - State:KS
Mailing Address - Zip Code:67578-2010
Mailing Address - Country:US
Mailing Address - Phone:620-234-5221
Mailing Address - Fax:620-234-5792
Practice Address - Street 1:412 GRAND AVE
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:KS
Practice Address - Zip Code:67578-2010
Practice Address - Country:US
Practice Address - Phone:620-234-5221
Practice Address - Fax:620-234-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS178558Medicare Oscar/Certification