Provider Demographics
NPI:1992341473
Name:MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS
Entity type:Organization
Organization Name:MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:JANSSENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-556-2459
Mailing Address - Street 1:1619 K66
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:KS
Mailing Address - Zip Code:66739-4306
Mailing Address - Country:US
Mailing Address - Phone:620-783-1732
Mailing Address - Fax:
Practice Address - Street 1:1619 K66
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:KS
Practice Address - Zip Code:66739-4306
Practice Address - Country:US
Practice Address - Phone:620-783-1732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
No282N00000XHospitalsGeneral Acute Care Hospital