# KIOWA DISTRICT HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KIOWA DISTRICT HOSPITAL
- **Other names:** Kiowa Hospital District Man4
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043273378
- **Legal business name:** KIOWA DISTRICT HOSPITAL
- **Authorized official:** JANELL LYN GOODNO (CEO/CFO)
- **Authorized official phone:** (620) 825-4131

## Contact information

- **Practice address:** 1020 MAIL STREET, KIOWA, KS 67070
- **Practice address phone:** (620) 825-4131
- **Practice address fax:** (620) 825-4667
- **Mailing address:** 1002 S 4TH ST, KIOWA, KS 67070-1825
- **Mailing address phone:** (620) 825-4131
- **Mailing address fax:** (620) 825-4667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 17E597 | KS | Yes |

## Other

- **Enumeration date:** 04/08/2006
- **Last updated:** 11/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100111440A | — | KS |
| 01 | — | N004002 | STATE LICENSE | KS |