Provider Demographics
NPI:1366716508
Name:STANTON COUNTY HOSPITAL
Entity type:Organization
Organization Name:STANTON COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:TUSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-492-6250
Mailing Address - Street 1:404 N CHESTNUT ST
Mailing Address - Street 2:P.O. BOX 639
Mailing Address - City:JOHNSON
Mailing Address - State:KS
Mailing Address - Zip Code:67855-5001
Mailing Address - Country:US
Mailing Address - Phone:620-492-1400
Mailing Address - Fax:620-492-1608
Practice Address - Street 1:404 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:KS
Practice Address - Zip Code:67855-5001
Practice Address - Country:US
Practice Address - Phone:620-492-1400
Practice Address - Fax:620-492-1608
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STANTON COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty