Provider Demographics
NPI:1912081118
Name:HIAWATHA HOSPITAL ASSOCIATION INC
Entity type:Organization
Organization Name:HIAWATHA HOSPITAL ASSOCIATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-742-2131
Mailing Address - Street 1:300 UTAH ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2314
Mailing Address - Country:US
Mailing Address - Phone:785-742-2131
Mailing Address - Fax:785-742-6588
Practice Address - Street 1:300 UTAH ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2314
Practice Address - Country:US
Practice Address - Phone:785-742-2131
Practice Address - Fax:785-742-6588
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIAWATHA HOSPITAL ASSOCIATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282NC0060X
KSH007001275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS001168OtherBLUE CROSS PROVIDER NUMBE
KS17Z341Medicare ID - Type UnspecifiedPROVIDER NUMBER
KS001168OtherBLUE CROSS PROVIDER NUMBE