Provider Demographics
NPI:1699877050
Name:RUSH COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:RUSH COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOVORKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-514-5619
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:801 LOCUST
Mailing Address - City:LA CROSSE
Mailing Address - State:KS
Mailing Address - Zip Code:67548-0520
Mailing Address - Country:US
Mailing Address - Phone:785-222-2545
Mailing Address - Fax:785-222-2868
Practice Address - Street 1:801 LOCUST
Practice Address - Street 2:
Practice Address - City:LACROSSE
Practice Address - State:KS
Practice Address - Zip Code:67548-0520
Practice Address - Country:US
Practice Address - Phone:785-222-2545
Practice Address - Fax:785-222-2868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH-083-001261QR1300X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003941880003Medicaid