Provider Demographics
NPI:1902999147
Name:SCOTT COUNTY HOSPITAL
Entity type:Organization
Organization Name:SCOTT COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:D. MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-872-5811
Mailing Address - Street 1:1602 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67871-5095
Mailing Address - Country:US
Mailing Address - Phone:620-872-2232
Mailing Address - Fax:620-872-5012
Practice Address - Street 1:1602 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:KS
Practice Address - Zip Code:67871-5095
Practice Address - Country:US
Practice Address - Phone:620-872-2232
Practice Address - Fax:620-872-5012
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCOTT COUNTY HOSPITAL DBA HORIZON HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1000916706Medicaid
KS48631OtherBCBS
KS1000916706Medicaid