Provider Demographics
NPI:1144632035
Name:ST CATHERINE HOSPITAL
Entity type:Organization
Organization Name:ST CATHERINE HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:STIEBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-227-6661
Mailing Address - Street 1:2200 SUMMERLON CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-2900
Mailing Address - Country:US
Mailing Address - Phone:620-227-6661
Mailing Address - Fax:620-227-7655
Practice Address - Street 1:2200 SUMMERLON CIR
Practice Address - Street 2:SUITE B
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2900
Practice Address - Country:US
Practice Address - Phone:620-227-6661
Practice Address - Fax:620-227-7655
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST CATHERINE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
114136Medicare PIN