Provider Demographics
NPI:1285721944
Name:CITIZENS MEDICAL CENTER, INC
Entity type:Organization
Organization Name:CITIZENS MEDICAL CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:UNRUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-462-7511
Mailing Address - Street 1:100 EAST COLLEGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-3796
Mailing Address - Country:US
Mailing Address - Phone:785-462-7511
Mailing Address - Fax:785-460-4870
Practice Address - Street 1:100 EAST COLLEGE DRIVE
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-3796
Practice Address - Country:US
Practice Address - Phone:785-462-7511
Practice Address - Fax:785-460-4870
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITIZENS MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-06
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100098840AMedicaid
KS17 1362Medicare ID - Type Unspecified