Provider Demographics
NPI:1730185174
Name:EMPORIA SURGICAL HOSPITAL, LLC
Entity type:Organization
Organization Name:EMPORIA SURGICAL HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-342-8822
Mailing Address - Street 1:1602 W 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-0984
Mailing Address - Country:US
Mailing Address - Phone:620-342-8822
Mailing Address - Fax:620-342-8832
Practice Address - Street 1:1602 W 15TH AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-0984
Practice Address - Country:US
Practice Address - Phone:620-342-8822
Practice Address - Fax:620-342-8832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSH056002282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS001523OtherBLUECROSS BLUE SHIELD
KS503710OtherFIRST GUARD
KS170193Medicare ID - Type Unspecified