Basic Information
| Provider Information | |||||||||
| NPI: | 1447243035 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LINDSBORG COMMUNITY HOSPITAL ASSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 605 W LINCOLN ST | ||||||||
| Address2: | |||||||||
| City: | LINDSBORG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674562328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852273308 | ||||||||
| FaxNumber: | 7852274130 | ||||||||
| Practice Location | |||||||||
| Address1: | 605 W LINCOLN ST | ||||||||
| Address2: | |||||||||
| City: | LINDSBORG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674562328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852273308 | ||||||||
| FaxNumber: | 7852274130 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GENGLER | ||||||||
| AuthorizedOfficialFirstName: | LARAINE | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 7852273308 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171W00000X | 023086 | KS | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Contractor |
ID Information
| ID | Type | State | Issuer | Description | 012231 | 01 | KS | LCH-CRNA-BCBS | OTHER |