Provider Demographics
NPI:1538227327
Name:SUBLETTE HOSPITAL DIST
Entity type:Organization
Organization Name:SUBLETTE HOSPITAL DIST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-675-8466
Mailing Address - Street 1:PO BOX 980
Mailing Address - Street 2:
Mailing Address - City:SUBLETTE
Mailing Address - State:KS
Mailing Address - Zip Code:67877
Mailing Address - Country:US
Mailing Address - Phone:620-675-8466
Mailing Address - Fax:620-675-8496
Practice Address - Street 1:101 N CODY
Practice Address - Street 2:
Practice Address - City:SUBLETTE
Practice Address - State:KS
Practice Address - Zip Code:67877
Practice Address - Country:US
Practice Address - Phone:620-675-8466
Practice Address - Fax:620-675-8496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00307085OtherRR MEDICARE
KS005740OtherBCBS OF KS
005740Medicare ID - Type Unspecified