Provider Demographics
NPI:1427131515
Name:HANOVER HOSPITAL
Entity type:Organization
Organization Name:HANOVER HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:D
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-337-2214
Mailing Address - Street 1:205 S. HANOVER STREET
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:KS
Mailing Address - Zip Code:66945
Mailing Address - Country:US
Mailing Address - Phone:785-337-2214
Mailing Address - Fax:785-337-2727
Practice Address - Street 1:205 S. HANOVER STREET
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:KS
Practice Address - Zip Code:66945
Practice Address - Country:US
Practice Address - Phone:785-337-2214
Practice Address - Fax:785-337-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS00197OtherBLUE CROSS BLUE SHIELD
KS10098950AMedicaid
KS171365Medicare ID - Type UnspecifiedMEDICARE
KS17Z365Medicare Oscar/Certification